Christmas wishes to all our readers!

Sally and Adele and all the library staff at CHHC and PMBH would like to wish you a very merry Christmas. Our experiments in blogging seem to be working nicely, with an average of over 700 visits a month and lots of repeat visitors and subscribers.

The picture to the right is a book tree constructed at our library in Port Macquarie by Helen from old bound journals. It's attracted a lot of attention here!
All the very best for a safe and happy festive season and we look forward to continuing this service into 2009.

Musical health dangers!

The British Medical Journal has published two articles recently on this topic.

"Head and neck injury risks in heavy metal : head bangers stuck between rock and a hard bass" by Declan Patton & Andrew MacIntosh in Vol 337, Dec 20-27 2008, p. 1455-7, has had a fair bit of airing in the media recently. More than slightly tongue-in-cheek, the authors conclude that to minimise the risk of head and neck injury, "head bangers should decrease their range of head and neck motion, head bang to slower tempo songs by replacing heavy metal with adult oriented rock, only head bang to every second beat, or use personal protective equipment."

A little more seriously, "A Symphony of Maladies" in the same issue, p.1458-60, discusses at length the health stresses professional classical musicians face, from the obvious overuse injuries and the fallout from gruelling practice and travelling regimes, to focal dystonias, dermal sensitisation, and respiratory, oropharyngeal, and cardiovascular anomalies. Fiddlers' neck, Guitarists' nipple and Cello knee are some of the more specific complaints recorded in this literature review.

You can access these articles via the NCAHS online journals list, or contact your library for a copy.

National drug survey report

In another AIHW report just released, 2007 National Drug Strategy Household Survey: detailed findings, information on drug use prevalence, drug-related behaviours and incidents, and support for drug-related policy and legislation in Australia is presented.

Some of the findings include the fact that one in six Australians over the age of 14 smoke tobacco daily, a drop since 1993 when it was one in four. The use of ilicit drugs in Australia has continued to decline, and the consumption of alcohol has remained almost the same.

Cancer in Australia 2008 - AIHW Report

Cancer in Australia: an overview 2008 presents comprehensive national data on cancer incidence and mortality in Australia in 2005, with projections to 2008. Also included are incidence data by state and territory,remoteness, socioeconomic status and Indigenous status. Summaries are given for cancer survival and prevalence, and cancer screening. Also presented are hospital inpatient statistics for the period 2002-03 to 2006-07, and a discussion of the burden of cancer.

The report reveals an increased prevalence of cancer diagnosis across Australia, but also increased survival times for most forms of cancer

Comprehensive womens' medicine website

The Global Library of Women's Health has been developed from the six-volume, encyclopaedic textbook Gynecology & Obstetrics, which was first published in 1934 and has been edited for the last 30 years by Professor John J. Sciarra. It is like a huge online textbook containing 442 main chapters and 53 supplementary chapters, supported by over 40,000 references kept permanently up-to-date. The chapters have been written by more than 650 specialists. Also included are videos, an image library, atlases and patient information sheets.

There is free access to the whole site, including a health professionals section you need to register for, but which costs nothing.

NSW Rural & Remote Health Conference

Presentations from the inaugural NSW Rural & Remote Health Conference: Information/Inspiration/Innovation held in Coffs Harbour, November 2008 are now available from the NSW Institute of Rural Clinical Services & Teaching website.

Dynamic spread of happiness!

The paper in BMJ (British Medical Journal) that received the widest coverage last week shows that happiness is contagious and can spread from person to person. It was the most read article on the BMJ Site, with 12,327 viewers. Authors James H Fowler and Nicholas A Christakis followed 4739 participants from 1983 to 2003. By studying social networks, the researchers found that happy people are more likely to be connected to other happy people. They also found that people at the centre of their social network were more likely to be happy than those on the periphery of it.

Plenty of Guidelines, but Where's the Evidence?

Clinical guidelines were first developed in the 1980s, but even now over 20 years later, the process for creating guidelines can be idiosyncratic and error-prone, especially in regard to children’s health, leading to sudden shifts that confuse doctors and parents.
A report in The Journal of the American Medical Association found that only about a third of clinical guidelines reviewed current medical evidence. Fewer than half followed any kind of standard format. And yet we know that Evidence-based guidelines are critical to protecting public health from bad medicine. You can read the essay on the New York Times website.

Gestational diabetes in Australia

The Australian Institute of Health and Welfare recently released this report - the first national one of its type. Entitled Gestational Diabetes Mellitus in Australia 2005-6, the report uses data from the National Diabetes Services Scheme and the National Hospital Morbidity Database to determine the number of cases of GDM among Australian women of child-bearing age. Trends in the incidence of the condition over time, and a study of the high-risk groups (such as women aged over 30 years, women who identify as Aboriginal or Torres Strait Islander and women born overseas) are the main focus.

ABC's Radio National's Health Report this week featured an interview with the AIHW's Mardi Templeton concerning this report. You can download the audio or read the transcript.

Failures in Aboriginal health

Former Australian of the Year, Professor Fiona Stanley, delivered the 11th Annual Hawke Lecture in Adelaide last month. Now it is available online in pdf or as an audio podcast. The Great injustice : why we have failed to improve the health of aboriginal people is the title of the lecture, and in it Stanley discusses Aboriginal suicide rates, early mortality and the ongoing effects of the stolen generation.

"The most sustainable and important recommendation I want to discuss relates to how we enhance an effective Aboriginal workforce, as not only does that bring economic power to families, but also raises self esteem and longer term success. I will ... leave you with a commitment and a sense of hope that we can and must collectively tackle this major human rights issue in Australia."

Australian e-Journal for the Advancement of Mental Health

The latest issue of this journal (Volume 7, Issue 3, November 2008) has just been published free online. Articles include:

• In young people with a depressive disorder, does diagnostic specificity matter in the prediction of suicidality? Polarisation and political correctness: subtle barriers to consumer participation in mental health services.
• Increasing child and adolescent mental health content in undergraduate occupational therapy, social work and nursing programs: Lessons learnt.
• Sleep disruptions and mental health of primary caregivers of persons with disability due to chronic mental and physical conditions in the Australian population.
• Does family intervention for adolescent substance use impact parental mental health? A systematic review.
• Use of the Strengths and Difficulties Questionnaire in identifying emotional and behavioural problems in children of parents with a mental illness in Australia.
• The psychic disequilibrium of adoption: stories exploring links between adoption and suicidal thoughts and actions.
  

New melanoma guidelines

Just in time for summer, the NHMRC has published its Clinical practice guidelines for the management of melanoma in Australia and New Zealand, "developed by an expert team to provide the evidence for optimal care to assist general practitioners, dermatologists, surgeons and others in clinical decision making when managing patients with melanoma."

Figures from 2002 revealed melanoma to be the fourth most common cancer and the ninth most common cancer causing death, in Australia and New Zealand. Melanoma incidences continue to be substantially higher in these countries than reported worldwide. Early detection, referral to specialists and some sun exposure to maintain Vitimin D levels are all recommended. Population based screening is not supported by these guidelines.

Palliative Care Knowledge Network

CareSearch is funded by the Australian Government’s Dept of Health & Ageing, and aims to provide quality information and evidence on all issues relevant to palliative care. Because at any time a patient’s condition may change so that they require palliative care, CareSearch is relevant to nearly all fields of healthcare and different professionals. There is also extensive evidence-based information available there for patients and carers.

Librarians have run over 50 different topic searches related to palliative care and these are included on the site and regularly updated. The most recent are on Dysphagia and Quality of Life. This is really an excellent informational website, well worth keeping a regular eye on.

The Garling Report

Just in case you have missed all the hype surrounding the Garling Report released last Friday, here is a link to the Final Report of the Special Commission of Inquiry into Acute Care Services in NSW Public Hospitals. Consisting of three volumes, you can download it for free.

Projections of Australia's Healthcare Expenditure

The Australian Institute of Health and Welfare released a new report yesterday:
Projection of health care expenditure by disease 2003 to 2033. This report examines projections of Australian health care expenditure by disease for the period 2003 to 2033. Total expenditure on health is projected to increase from 9.4% of GDP in 2002-03 to 10.8% of GDP in 2032-33. This is an increase of 15% in the health to GDP ratio (or an annual growth of 0.5% greater than growth in GDP). The report:
- provides details on the five components of the projection model
- presents expenditure projections to 2033 for the 20 disease groups
- examines the main components contributing to change in expenditure for seven major disease and injury groups.

New policy on Men's Health

The Australian Government has announced the development of a National Men's Health Policy. They are seeking comments and feedback from all Australian men during the consultation phase and there are several discussion and issues papers available to start off the process.

"The Policy will focus on reducing barriers men experience in accessing health services, tackling widespread reticence amongst men to seek treatment, improving male-friendly health services, and raising awareness of preventable health problems that affect men."

Caring for older Australians at home: new resource for community aged care

A new information resource has been launched to give service providers and care workers a blueprint for providing better care for older people.
The Research to Practice briefings, prepared by The Benevolent Society and the Social Policy Research Centre, aim to bring research evidence to community aged care workers in a user-friendly way, so that they and the older people they work with can benefit from putting evidence into practice.
The first briefing in the series is "Caring for Older Australians: Care workers and care practices that support and enable good care". The second briefing in the series, "Promoting social networks for older people in community aged care" will be released in early 2009. Briefings will be produced 3 times a year in hard copy format and on the internet.
Press Release

Reposted from GWAHS Libraries Blog

Egg Consumption and Risk of Type 2 Diabetes in Men and Women.

A new study published in Nov 18, 2008 issue of Diabetes Care suggests that eating eggs increases risk of type 2 diabetes both in men and women. For the study, the researchers looked at data from two completed randomized trial involving 20,703 men from Physicians' Health Study I (1982 to 2007) and 36,295 women from the Women’s Health Study (1992-2007). Diabetes was more common in men and women who reported eating more than the average one egg a week.
Medpage Today has given a good summary of the article, but if you would like to read the full article you will need to contact your Librarian. DiabetesNSW has also summarized the findings on their news page.

Women and exercise

The Office for Women in the Australian Department of Families, Housing, Community Services, and Indigenous Affairs has just released a report on this topic authored by Professor Wendy Brown, Dr Nicola Burton and Dr Kristiann Heesch, Physical activity and health in mid-age and older women.

The benefits of physical activity are well known and this report found that between 2001 and 2004, the percentage of mid-aged women doing 30 minutes of physical activity on most days rose from 45 to 54 per cent - primarily attributed to walking.

Australian guidelines recommend 30 minutes of moderate intensity physical activitiy on most days of the week for health benefits. The evidence reviewed in this report suggests that middle-aged or older women gain few, if any, additional health benefits from any more vigorous exercise than this. Interesting.

The Latest on Cochrane

If you need to access high-quality, independent evidence, the Cochrane Library reviews bring you the combined results of the world’s best medical research. The latest issue of the Cochrane Library included the following reviews:
*Mouth rinses for the treatment of halitosis
*Probiotics for treating eczema
*St John's wort for major depression
*Regular treatment with formoterol for chronic asthma: serious adverse events
*Combined intermittent pneumatic leg compression and pharmacological prophylaxis for prevention of venous thromboembolismin high-risk patients
*LHRH agonists for adjuvant therapy of early breast cancer in premenopausal women.
*Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women.
These reviews can be accessed at the Cochrane Library.

Pearls

PEARLS are short practical summaries of the evidence in relation to specific topics, derived from Cochrane Systematic Reviews. They have been developed by the Cochrane Primary Care Field, New Zealand Branch of the Australasian Cochrane Centre at the Department of General Practice and Primary Health Care, University of Auckland and funded by the New Zealand Guidelines Group. PEARLS provide guidance on whether a treatment is effective or ineffective. PEARLS are prepared as an educational resource and do not replace clinician judgment in the management of individual cases. You can access PEARLS from the New Zealand Doctor website.

UNICEF report on the world's children

The State of the World's Children 2008 : Child Survival has just been made available as a 164 page report from Unicef.

"It provides a wide-ranging assessment of the current state of child survival and primary health care for mothers, newborns and children. It examines lessons learned in child health during the past few decades and outlines the most important emerging precepts and strategies for reducing deaths among children under age five and for providing a continuum of care for mothers, newborns and children".

Many developing countries have reduced child deaths over the past 25 years, which is cause for optimism. However, every day an average of 26,000 children under the age of five die around the world, mostly from preventable diseases and mostly in 60 developing countries, so much work is still needed.

More help needed for those with intellectual disability

The AIHW has recently released a report called Disability in Australia: intellectual disability. It presents an overview of the prevalence of intellectual disability and its related impairments, health conditions and activity limitations across the age spectrum.

In 2003 436,000 people were living in Australia with an intellectual disability, and most of them were living at home. 60% of these people needed help with things like learning, making decisions, and managing emotions; 33% needed help with mobility, 27% with communication and 24% with self-care. 38% reported that these needs were only partially met or not met at all.

Australian Diabetes Map

There are currently 918,218 people in Australia diagnosed with some form of Diabetes, according to The National Diabetes Services Scheme (an initiative of the Australia Government, administered by Diabetes Australia).

The NDSS has just released an Australian Diabetes Map, searchable by state, electorate or post code, which shows the numbers of people diagnosed with diabetes in all parts of Australia including information on age, gender and type of diabetes. Type 2 is the most common form of the disease, women are slightly more likely to suffer from Diabetes than men, and the most prevalent age group is 60-69.

Australia Measures Up!

A national Measure Up campaign to tackle obesity, and ultimately to save lives, was launched in October as part of the Australian Better Health Initiative - a joint Australian, State, and Territory government program that aims to reduce the prevalence of risk factors for chronic disease, limit the incidence and the impact of these diseases, and reduce morbidity and mortality rates. Measure Up encourages Australians to measure their waists so that they can tell whether they are at risk of developing a lifestyle-related chronic disease.
HealthInsite, an Australian Government Initiative has a number of related topic pages on obesity, cholesterol, diabetes and eating well for adults and children.

Improve Your Health Now

Losing as little as five to ten kilograms can make a big difference to your cholesterol levels, and significantly reduce your risk of heart attack or stroke according to Professor David Colquhoun writing in the October 2008 issue of Australian Prescriber. The recent article highlights the much-vaunted benefits of losing weight to improve your health now, and to prevent the onset of chronic disease in the future. “If these improvements can be made through changes to diet, weight loss, exercise and the use of special nutrient-rich or fibre-rich foods, there may be no need to take cholesterol lowering medicines,” he says.
Consistent with this theme, all Australian governments have launched a campaign to tackle obesity: Measure Up. It's designed to assist Australians to assess their risk of developing lifestyle-related chronic diseases.

International Program of Psycho-Social Health Research

IPP-SHR is a collaborative initiative jointly funded by the National Health and Medical Research Council and CQUniversity. The primary aim of this international program in research is to examine and document the human experience of serious illness (both physical and mental). IPP-SHR is a broad program addressing a wide range of topic areas including: haematology/oncology; mental health; palliative care; acute medicine; bioethics; rural and remote health; Indigenous health; spirituality; paediatrics; birth studies; and service delivery evaluation.
In essence the program is concerned with contributing to the development of psycho-social services that assist people to deal with the many challenges associated with serious physical and/or mental illness. The core work is to ‘make a difference’ and this is achieved through research, publication, education and consultancy activities. On the IPP-SHR website there are Projects, Programs and a large number of podcasts on such topics as Eating Disorders, Early-Stage Alzheimer's Disease, Humour in Critical Care Settings, Drug Administration Errors, Assessing Cardiovascular Risk and Pediatric Pain Management.

What is Podcasting?

Podcasting is a new format of broadcasting that uses internet technologies to allow you to listen to audio over the internet, at a time and place convenient to you.
Such audio can be traditional radio shows, pre-recorded audio shows or specifically designed podcast shows. You can listen to a Podcast by clicking on the audio link, or you can download it to listen to at a later date.
Subscribing to the podcast, will allow you to automatically receive the podcast as soon as each new episode is published. When a new podcast is published you will receive an email containing a link to the podcast audio.

The Credit crisis and health care

This is the title of a very apt article by John Appleby in this week's BMJ.
"It is hard to resist apocalyptic phrases (indeed, the use of the word apocalyptic) in describing the effect of the credit crunch on the world’s banking and financial systems over the past year. But it is not just the somewhat unreal and mystifying world of credit default swaps, naked short selling, and eyewatering bonuses that has been affected. As has become much clearer in the past few months the scale of the seizure in wholesale credit markets is such that the effects are being felt in the real world."
Appleby, an economist, goes on to discuss the likely repercussions of the crisis on the NHS. He suggests that health care is about to have an unavoidably difficult future.
BMJ 2008;337:a2259.

Product nutrition and consumer information

The NSW Public Health Bulletin this month includes an important paper by Jimmy Chun-Yu Louie and others: A comparison of two nutrition signposting systems for use in Australia.
Consumers are interested in making healthier food choices but the mandatory nutrition information panel currently in use in Australia is not easily understood or interpreted by most consumers. This paper reviews two nutrition signposting systems currently being considered for adoption in Australia to make the information more obvious. The authors conclude that a system similar to the colour-coded Traffic Light System is likely to be most useful.

Developed by the Food Standards Agency in the UK, where it is currently used, the CCTL system categorises the four key nutrients most associated with public health issues (fat, saturated fat, sugars and salt) as high, medium or low compared to a set of agreed criteria. This information is then portrayed as red, amber or green traffic lights on the package. The authors acknowledge there are limitations to this system but favour it with some modification.

Climate Change and Health

The National Climate Change Adaptation Research Facility, based at Griffith University, has just released a report named National adaptation research plan (human health): consultation draft. Penned by A.J. McMichael and others, the report aims to guide researchers in developing strategies to cope with the health risks associated with climate change. The main risks are identified as deriving from:

• Extreme weather events and disasters
• Temperature extremes
• Air quality and pollutants
• Environmental infectious diseases borne by water and food
• Vector-borne infectious diseases
• Altered food production - affecting yield and nutritious quality
• Social, economic and demographic dislocation - especially relating to mental health.
  

Medical labour force 2006

The overall supply of medical practitioners in Australia rose between 2002 and 2006, while the primary care doctor supply fell, according to a report (free online) released on Friday by the Australian Institute of Health and Welfare (AIHW). Major cities (at 332 FTE per 100,000) had the largest supply of medical practitioners, followed by inner regional areas (at 184) and outer regional areas at 154 FTE.The report is based on the main findings of the 2006 national survey of registered medical practitioners. Information presented includes a national and state/territory overview of the number of medical practitioners (including age and sex, field of medicine, working hours and where they work), their geographic region and overall supply.

How do we improve the quality of our patients' care?

Worldwide, 30-40% of patients do not receive care that is based on the best possible research evidence. How do we turn this around?
In this podcast, world renowned director of the Centre for Quality Care of Research in the Netherlands, Professor Richard Grol, says the answer lies in patient centred organisation of care and improved communication between health professionals. Although the concept of health professionals working together for the good of the patient appears obvious, this is sometimes difficult to apply in the busy and complex hospital environment. Care needs to be better organised to meet the needs of patients rather than those of health professionals. This can be achieved through evidence-based guideline implementation programs and a greater focus on standardisation of processes and procedures.

Ambulance Protocols now on CIAP

CIAP has recently published the the NSW Ambulance Protocols and Pharmacologies for the Ambulance Service of NSW (ASNSW). You will find these protocols under ‘Useful Links’ from the top of the CIAP website and you will need to use your facility’s CIAP username and password to access.
There are about 80 protocols divided into subgroups such as surgical, cardovascular, trauma and environmental, and a number of summaries of common therapeutic drugs.
CIAP has changed the look of its website over the past couple of weeks. I'm sure you'll find no problems using the site, but be sure to contact your Library or the CIAP helpdesk if you have any concerns.

National Survey of Mental Health and Wellbeing

The Australian Bureau of Statistics has just released a summary from this 2007 survey. Their report provides information on the prevalence of three major disorder groups: anxiety disorders, affective disorders and substance use disorders. It also provides information on the level of impairment, the health services used for mental health problems, physical conditions, social networks and caregiving, as well as demographic and socio-economic characteristics.

Among the results are the disturbing facts that "of the 16 million Australians aged 16-85 years, almost half (45% or 7.3 million) had a lifetime mental disorder, ie a mental disorder at some point in their life. One in five (20% or 3.2 million) Australians had a 12-month mental disorder."

Read the report summary at http://www.abs.gov.au/AUSSTATS/abs@.nsf/mf/4326.0

Morbidity and Mortality Reports

The MMWR Recommendations and Reports contain in-depth articles that relay policy statements for prevention and treatment on all areas in CDC's scope of responsibility. Some of the reports this year include:
* Recommendations for Identification and Public Health Management of Persons with Chronic Hepatitis B Virus Infection
*Prevention and Control of Influenza
*Prevention of Pertussis, Tetanus, and Diphtheria Among Pregnant and Postpartum Women and their Infants.

Food Ministers Consider Food Labelling Review

The twelfth meeting of the Australia and New Zealand Food Regulation Ministerial Council (Ministerial Council) was held in Adelaide on Friday. The meeting agreed in principle to commission an independent, comprehensive review of food labelling law and policy. The Ministerial Council received a report from the Food Regulation Standing Committee (FRSC) on front of pack labelling of food that provides consumers with easily accessible information on the health status of the contents. The Ministerial Council had asked for an investigation on whether a front of pack (FOP) labelling scheme would be an effective health strategy to guide consumer choice towards healthier food options.

ABC Health Report - Asthma and Primary Care

Just to follow up on our postings of yesterday and 20 October, the ABC Radio National Health Report featured the AIHW's Asthma study as well as the WHO Primary Health Care report on their program last Monday. You can listen to the whole show online, or download if for your later enjoyment if you missed the broadcast.

Primary Health Care – Now More Than Ever

This is the title of WHO's World Health Report 2008. The Report asks why the principles of Primary Health Care, put forward thirty years ago, are falling short even in the most developed countries. "Globalization is putting the social cohesion of many countries under stress, and health systems are clearly not performing as well as they could and should. People are increasingly impatient with the inability of health services to deliver. Few would disagree that health systems need to respond better – and faster – to the challenges of a changing world."

New patient e-health 2.0 sites

Two new websites have been launched featuring a collection of real life health stories and personal experiences of illness and health.
The two sites, Healthtalkonline, and Youthhealthtalk, have replaced DIPEx, a site created by Dr Ann McPherson, an Oxford GP, and Dr Andrew Herxheimer, former editor of the Drug and Therapeutics Bulletin.
The charity says the new sites include the UK’s largest collection of real life health stories and aim to support individuals who feel isolated as a result of a particular conditions featuring patients talking on videos and on audio clips as well as through transcripts. Topics covered include cancer, heart disease, chronic pain, bereavement, diabetes, epilepsy and women’s health.
Broadcaster Jon Snow and author Philip Pullman were among those who took part in the launch. Jon Snow, patron of the charity, said listening to the experiences of others could help people to better understand and cope with their illnesses.
“Healthtalkonline provides a medically endorsed forum for this kind of support,” he added.
All content on the site is based on research carried out by academics from Oxford University from interviews with almost 200 people. The charity says the sites are designed to be a useful resource for clinicians who want to better understand people’s perspectives as well as patients.
The dedicated site for young people, Youthhealthtalk, has been promoted by the singer Thom Yorke of the band Radiohead. It includes sections on epilepsy, sexual health and teenage cancer.
The charity said the new sites include greatly improved accessibility, enhanced navigation and comprehensive search facilities. DIPEx is funded by the Department of Health and charitable trusts.
Links
Healthtalkonline http://www.healthtalkonline.org/
Youthtalkonline http://www.youthhealthtalk.org/

Virtual special issue on mental health (Australian Journal of Rural Health)

Another compilation of research in a virtual special issue, this one 22 articles on rural mental health topics. Subjects covered include an overview of rural mental health, rural health-seeking behaviours, climate change and mental health, the role of rural financial counsellors in early intervention, traditional aboriginal health beliefs and lots, lots more ...

Asthma in Australia 2008 (AIHW)

Asthma remains a significant health problem in Australia, with prevalence and death rates that are high by international standards despite declines, according to a report released today by the Australian Institute of Health and Welfare (AIHW).
The report, Asthma in Australia 2008, estimates that asthma affects more than 1 in 10 Australians - equivalent to over 2 million people. This report brings together data from a wide range of sources to describe the current status of asthma in Australia. It includes information on the number of people who have asthma and who visit their GP, are hospitalised or die due to asthma. Time trends and profiles of people who receive various treatments for asthma are also presented, along with information on those who have written asthma action plans. In addition, comorbidities and quality of life among people with asthma are investigated. Also included is a chapter on asthma among Aboriginal and Torres Strait Islander Australians.

Evidence databases in allied health

If you're an Occupational Therapist or a Physiotherapist, I'm sure you already know about these free databases, developed in Australia. But just in case you don't, or for those in related professions who might find them useful, here's the lowdown...

PEDro, developed in the University of Sydney, has been around for many years now. It's aim is "to give rapid access to bibliographic details and abstracts of randomised controlled trials, systematic reviews and evidence-based clinical practice guidelines in physiotherapy."

OTseeker is relatively new, only beginning in 2002. The compilers have adapted the guidelines and methods used by PEDro to branch into the Occupational Therapy field and are based in the University of Queensland and the University of Western Sydney.

Health information on the Internet - a challenge for professionals

Louise Donnelly and others have recently published "eHealth as a challenge to 'expert' power: a focus group study of internet use for health information and management". J R Soc Med. 2008 Oct;101(10):501-6.
The numbers of households with access to the Internet has meant journal articles, medical information and medical libraries are increasingly accessible. In 2003, the World Health Organization (WHO) identified over 100,000 health-related websites in operation, with other generic sites totalling 60 million. What does this mean for health professionals? The authors conclude, "Our findings illustrate changes in patient identity and a decline in expert authority with ramifications for the practitioner–patient relationship and subsequent implications for health management more generally. "

New ear wax Guidelines

The American Academy of Otolaryngology has recently released a Clinical Practice Guideline : Cerumen Impaction. Essentially the guidelines reinforce what as patients we all know - nothing should be put in your ears by anyone who doesn't know what they are doing, as you risk damaging this delicate instrument. Syringing by a health professional is the go. I had this done after a particularly beachy summer a couple of years ago and it felt fantastic! The guidelines call for more research on different types of cerumen softeners and methods used to clear the ears, as well as a monitoring of the types of health care workers who perform the task.

Critical analysis for nurses

'A Nurses' guide to the critical reading of research' is an article by Rebecca Ingham-Broomfield in September's issue of the Australian Journal of Advanced Nursing. The author provides a framework for the systematic analysis of research papers in order to identify the strengths and weaknesses of research methods and thus the worth of particular studies. This is a straightforward and useful guide to a subject we Librarians are often asked to help with.

An invitation to participate in 'Australia : Healthiest Country by 2020'

The Preventative Health Taskforce appointed by Health Minister Nicola Roxon has just released a major discussion paper - Australia: the Healthiest Country by 2020 - with supporting technical reports, and is keen to consult with as many organisations, groups and individuals as possible on this and the National Preventative Health Strategy, which is the next stage in its work. A national series of consultation meetings is planned over the next few months, including two in Sydney late in November.
Details of the consultations may be found at http://www.preventativehealth.org.au/

Primary and Community Care Discussion Papers

To assist in its work to develop a long-term health reform plan for Australia, the National Health and Hospitals Reform Commission (NHHRC) invited discussion papers from authorities in the key areas of Primary and Community Care, Prevention, Governance, and Public-Private Mix. These papers are now available free online on the NHHRC website under 'Discussion Papers' and include:
* New Models of Primary Care and Community Care with a Focus on Rural and Remote Care;
* New and emerging nurse-led models of primary health care by Professor Mary Chiarella.

Medicine 2.0 - the Interactive Web

Many of you will have heard of Web 2.0, which refers to changing trends in the use of the Internet that aim to enhance creativity, information sharing and collaboration. This trend has led to such innovations as social-networking sites (like Facebook), video sharing sites (like U-Tube), wikis and blogs.

Adaptation of Web 2.0 technologies in the area of Medicine are now emerging for consumers, health professionals and biomedical researchers. Google Health, which allows for Personally Controlled Health Records, is an obvious example of this. Gunther Eysenbach is the author of an editorial in the Journal of Medical Internet Research, entitled "Medicine 2.0: Social Networking, Collaboration, Participation, Apomediation, and Openness." If you're interested in where all this new technology is heading, it makes for intriguing reading.

Understanding of Prostate Cancer

"Knowledge and attitudes of men about prostate cancer", is an article in the most recent issue of the Medical Journal of Australia, 189 (6): 312-314, by Diane E Arnold-Reed and others.

The authors report on a survey of Australian men in the 40-80 age group and conclude that 80% of the men did not know the function of the prostate, and 48% failed to identify prostate cancer as the most common internal cancer in men. 35% had no knowledge of the treatments for prostate cancer and 53% had no knowledge of the side effects of treatments. They conclude that "there is a deficit in knowledge about prostate cancer among men in the at-risk age group, encompassing areas that could delay diagnosis and treatment."

There's more to searching the Internet than Google

Of course Librarians are going to tell you that! There is good reason for Google being the most popular search engine out there, but don't blind yourself to other avenues to find general information on the Internet.

Mary Ellen Bates is an American Librarian who travels the world teaching other librarians and special interest groups how to get the most out of the Internet. Read her article, Life Beyond Google: Some of the Best of the Rest for an insight into some other ways to find general information online.

Drug use and mental health

This week's ABC Radio National Health Report includes a discussion with Professor Steve Allsop, Director of the National Drug Research Institute at Curtin University in Perth.

Professor Allsop has just launched a book he edited, "Drug Use and Mental Health", published by IP Communications. He says, "About 50% of the people who have mental health problems also have drug problems. It's a bit larger than that if people with drug problems also have mental health problems."

Treatment services for these people have been quite inadequate and there is a need to improve these services substantially. Allsop stresses the need for a more integrated approach to mental health and drug care, as well as the importance of the therapeutic relationship between patients and health care professionals.

Child and youth health - how is Australia faring?

"Making progress: the health, development and wellbeing of Australia's children and young people" is a report released today by the Australian Institute of Health and Welfare.
The report covers children and young people aged 0-19 years, and includes indicators for three different stages of development: infancy and early childhood; school age childhood; and adolescence. Information is presented on mental health, disability, risk factors for chronic disease, mortality, education, homelessness, crime, jobless families and family economic situation. Particular attention is given to Aboriginal and Torres Strait Islander children and youth, and to how Australia compares internationally.
One of the disturbing findings from this report is that the number of teenage girls who have been admitted to hospital for intentionally hurting themselves has risen by a third over the last decade. On the other hand, mortality rates for children under the age of 20 has actually fallen by a third and this decline is greater for males than for females.

Join the Stretching Trial

Does stretching before or after exercise really reduce the risk of injury and muscle soreness? Apparently this has never really been proven.

The University of Sydney along with the Norwegian Knowledge Centre for Health Services are currently running The Stretching Trial, which is the first trial designed to test the effect of stretching before and after exercise in recreational athletes. It’s a fully online trial which means people can participate from anywhere in the world.

If you're interested in joining the trial, click on the link above. You need to have email and Internet access and be a regular recreational exerciser.

New Dementia Resources

The Minister for Ageing, Mrs Justine Elliot last week launched three new dementia training resources as part of Dementia Awareness Week (which is this week). More than 200,000 Australians currently live with dementia; of those, there are about 10,000 people with younger onset dementia. In addition, the number of people with dementia is set to increase to almost 465,000 by 2031. The three new resources are:

• Local Knowledge, a dementia care e-learning resource for rural and remote aged care workers.
• Strangers in a Strange Land: Cultural Competence in Dementia Care, which focuses on people from culturally and linguistically diverse backgrounds.
• 2 Young 4 Dementia – Meeting the Needs of People with Younger Onset Dementia, which aims to support improved dementia awareness and care for younger people with dementia.

Copies of these resources are free - you just need to email mailto:dementia@health.gov.au

Report of trends in HIV and STIs in Australia

The National Centre in HIV Social Research at the University of NSW has just released the tenth in an annual series reviewing behavioural data relevant to the transmission HIV, viral hepatitis and other sexually transmissible infections.

HIV/AIDS, hepatitis and sexually transmissible infections in Australia: annual report of trends in behaviour 2008 edited by John Imrie and Andrew Frankland, examines behavioural and attitudinal data relevant to the formation and evaluation of prevention strategies and to understanding individuals’ experiences of treatment of these infections. It also includes data relating to the social aspects of treatment and care of those infected with hepatitis C virus and HIV.

What is the ERIC database?

ERIC - the Education Resources Information Center - is an online digital library of education research and information. ERIC is sponsored by the US Department of Education and aims to "support the use of educational research and information to improve practice in learning, teaching, educational decision-making, and research."

If you're looking for information of an education nature, you'll find ERIC a useful adjunct to other databases you use on CIAP. It has recently been revamped to make the searching quite easy, and although American-based, it does include some Australian journals and research. Items go back as far as 1966 and a new batch is entered twice weekly. Best of all - there is no charge for using it!

Maternity Services Review

Improving Maternity Services in Australia : A discussion paper from the Australian Government forms part of a review from the Department of Health and Ageing, which will lead to a comprehensive plan for maternity services into the future.

The Review of Maternity Services, led by the Commonwealth Chief Nurse and Midwifery Officer, Rosemary Bryant, aims to canvass a wide range of issues relevant to maternity services, including antenatal services, birthing options, postnatal services up to six weeks after birth, and peer and social support for women in the perinatal period. The government wants to ensure that all interested parties have an opportunity to contribute to the development of a National Maternity Services Plan and they areseeking submissions until the end of October from interested stakeholders in response to the paper.

Adherence to Mediterranean diet

The British Medical Journal reports this week that the Mediterranean diet, representing the dietary pattern usually consumed among the populations bordering the Mediterranean sea, has been widely reported to be a model of healthy eating for its contribution to a favourable health status and a better quality of life. Greater adherence to a Mediterranean diet is associated with a significant improvement in health status, as seen by a significant reduction in overall mortality (9%), mortality from cardiovascular diseases (9%), incidence of or mortality from cancer (6%), and incidence of Parkinson’s disease and Alzheimer’s disease (13%). These results seem to be clinically relevant for public health, in particular for encouraging a Mediterranean-like dietary pattern for primary prevention of major chronic diseases.

Big Week on the Health Calendar from the 15th

Next week is a big week on the NSW Health Calendar. Coming up from Monday the 15th of September is: Brain Injury Awareness Week, National Herbal Medicine Week, National Stroke Week, Sexual Health Week, and all of September is Dementia awareness month. On Friday the 19th of September is Diabetes Buzz Day. And at the end of September is World Retina Day organised by Retina Australia.

10 of the best research projects 2008

Australia has a proud history of producing groundbreaking health and medical research. This booklet, 10 of the best research projects 2008, showcases a selection of current projects and introduces some of the researchers who are continuing that tradition. Work on stem cells, diabetes, cancer, dental health and obesity in children are some of the research projects showcased here. Others include helping heal burns, making old wounds disappear, easing osteoarthritis and tackling male reproductive health. Together, these 10 represent the hundreds of highly successful international-standard projects the NHMRC funds each year.

New Nursing & Midwifery codes of ethics

The Australian Nursing and Midwifery Council has released the following new Professional Standards dated August 2008:
Code of Ethics for Nurses
Code of Professional Conduct for Nurses
Code of Ethics for Midwives
Code of Professional Conduct for Midwives

This is also the place to go for competency standards for RNs, ENs and Midwives.

Disabilities and OHS risks - no risk!

Su Mon Kyaw-Myint and others from the Office of the Australian Safety and Compensation Council (ASCC) undertook this research and have recently released their report entitled: Are people with disability at risk at work? : A review of the evidence.

This report indicates that workers with a disability are not an increased occupational health and safety risk. The research findings suggest that workers with a disability have on average, a lower number of OHS incidents and have lower workers’ compensation costs, in comparison to other employees.

Welcome to Bandolier

Bandolier, an online journal about evidence-based health care, is back after time off to recharge their batteries. This month they are presenting evidence on addictions, focusing on what works and how difficult it can be to stop, all from recent and updated systematic reviews. The first issue of Bandolier was printed in February 1994. It has appeared monthly ever since and has become the premier source of evidence based healthcare information in the UK and worldwide for both healthcare professionals and consumers.
The Knowledge Library Reviews on other topics can found in the Knowledge Library section of their website. In this section Bandolier collects good quality evidence under a variety of different headings. They search for systematic reviews of treatments, of evidence about diagnosis, epidemiology or health economics, and abstract it.

Depression: latest New Zealand Guidelines

Mental disorders are extremely common in primary care and are a major cause of disability. The most common disorders across populations are anxiety, depression and substance abuse. A new guideline has recently been launched called 'Identification of common mental disorders and management of depression in primary care'. The guideline has a wide scope with separate chapters on young people (focussing on adolescents), adults, women in pregnancy and the postnatal period and older adults. The assessment sections of the guideline also provide guidance on when (and how urgently) to refer to secondary mental health services. The treatment sections of the guideline address the management of depression in primary care and algorithms are provided. The full guideline and the summary guideline are now available online.

Social Determinants of Health - Final WHO Report

The World Health Organisation has just released this report, authored by their Commission of Social Determinants of Health, which is led by Sir Michael Marmot. (If you refer to our posting of 22 August, you can follow the links to listen to Marmot speaking on this topic).

The report is entitled "Closing the gap in a generation: Health equity through action on the social determinants of health." Their blurb reads: 'Social justice is a matter of life and death. It affects the way people live, their consequent chance of illness, and their risk of premature death. We watch in wonder as life expectancy and good health continue to increase in parts of the world and in alarm as they fail to improve in others.'

Coaching and admission to medical schools

While on interesting journal articles, this study was published by Barbara Griffin et al in the latest issue of the Medical Journal of Australia. (Remember, you need to register for access to this journal, but it's all free). "Does practice make perfect? The effect of coaching and retesting on selection tests used for admission to an Australian medical school"
The study was based at the University of Western Sydney and concluded that coaching and retesting improved UMAT scores only slightly in the non-verbal reasoning section of the paper, and may even have hindered candidates' performance on an MMI.

The walking for your memory study

This Australian study found that walking for two and a half hours a week can significantly improve memory in the over-50's - you've probably heard about it on the news over the past couple of days. The trial divided 170 people, who had reported memory problems but did not meet criteria for dementia, into two groups. One group continued their usual activities while the other took part in a 24 week home-based physical activity program. By the end of the trial, participants in the exercise group performed better on cognitive tests and had better delayed recall. Not only that, but the effects were still evident six to twelve months after completing the trial.

Professor Nicola T. Lautenschlager led this "Fitness for the Ageing Brain Study," conducted over 18 months at the University of Western Australia. The full paper is published in the Journal of the American Medical Association (JAMA), 300 (9) : 1027-37, and is entitled "Effect of physical activity on cognitive function in older adults at risk for Alzheimer Disease : a randomized trial."

Use your CIAP username and password to access this article here.

Illicit drug use and serious drinking continue to fall in NSW

The National Drug Strategy Household Survey: State and territory supplement published on August 29 follows the Survey's First Results report released in April 2008. Minister for Health Reba Meagher said new figures show there has been a continued decline in illicit drug use and high risk drinking in NSW. The survey found:
*illicit drug use has fallen from 14.6 p% in 2004 to 12.1% for 2007
*cannabis use fell from 10.7% in 2004 to 8% for 2007
*methamphetamine use decreased from 3.1% to 1.8% in 2007
*ecstasy use remained steady at 3.4% for 2007.
For alcohol use the survey found:
*low risk drinking decreased slightly from 49% in 2004 to 48.1% in 2007
*high risk drinking fell from 32.2% to 2004 to 31.8% in 2007
*daily drinking decreased from 8.8% in 2004 to 8.3% in 2007.
The results are based on a survey of more than 23,000 Australians conducted in 2007, and provide profiles of drug use and community attitudes in each of the states and territories.

Support programs for newly registered nurses

The latest edition of the Australian Journal of Advanced Nursing (now free online) includes an interesting article by Jennifer Evans, et al, entitled "The strengths and weaknesses of transitional support programs for newly registered nurses."

The researchers were concerned that the experiences of new graduate nurses moving from university to the workplace had not changed in the years since nurse training moved to the tertiary sector. They conducted their research in seven hospitals in and around Sydney and found that current transitional support programs had weaknesses in that there were times when the nurses worked without support and that there were often unrealistic expectations placed on the performance capabilities of these new graduates.

Medical Images on the Web

We are often asked to help clinicians find illustrations and photographs of anything from thoracic viscera to nasal polyps to old lithographs of leech therapy. Kindly, the McGoogan Library of Medicine at the University of Nebraska has set up a comprehensive site full of links to image collections freely available on the Internet. Look here to find that elusive illustration to enhance your presentation or just to set yourself straight.

Another fantastic image site, not linked from McGoogan, is Wellcome Images. Wellcome is the largest biomedical research charity in the UK. Their image collection is extensive and includes "themes ranging from medical and social history to contemporary healthcare and biomedical science." Their picture above is of a breast cancer cell.

Be sure to check any copyright, or other, restrictions on the individual image sites. Usually the images are freely available for research or education, but it's best to be sure. Always acknowledge the source if you're publishing them in any format.

The wealthy healthy: wellbeing's social determinants

What makes us healthy, and what keeps us well, and can societies can be made healthier?

In a recent broadcast, ABC Radio's The National Interest presented this panel discussion from the 2008 Fulbright Symposium in Adelaide. Five distinguished guests, including Sir Michael Marmot (Director, International Institute for Society and Health, University College, London), Dr David Satcher (former Surgeon General of the US) and our own Dr Carmen Lawrence and Pat Anderson, looked at how things like public transport or housing policy, the tax system or education spending, can improve our health. There is growing evidence to suggest the society in which we live can have a major impact on how well we are. Marmot uses the example of Costa Rica, which is a poor country with a high life expectancy for its citizens, and where there is no government spending on defence, but an emphasis on health and education.

You can download this program as a podcast or read the transcript here.

JoVE

The Journal of Visualized Experiments (JoVE) is now indexed in MEDLINE/PubMed. What is JoVE? Journal of Visualized Experiments (JoVE) is a video journal for biological research, ie the articles are in video. My favourite is "The Structure of Skilled Forelimb Reaching in the Rat: A Movement Rating Scale" from 8/8/08. Obviously the journal is geared more to science but worth a look as it is the first of its kind indexed on a medical database such as Medline and a look at the future.

Rural & Remote Health Conference in Coffs, 20-22 November, 2008

The draft program and registration information for the inaugural NSW Rural & Remote Health Conference: Information/Inspiration/Innovation which will be held at the Opal Cove Resort, Coffs Harbour, from 20th to 22nd November 2008, is now available. An essential addition to the conference calendar for anyone working in rural health.

ESSENTIAL Nursing Resources

THE 24TH EDITION of the ICIRN Essential Nursing Resources list (12 pages only free online) edited by Jacobs and Berolucci is presented as a resource for locating nursing information and for collection development. The list includes print, multimedia, and electronic sources to support nursing practice, education, administration, and research activities. The most recent editions or websites available are included. The list was compiled to point to pathways for exploration, rather than be an end point, and to expand to multiple formats beyond traditional references. New sections in this edition are: Alerting Services / Blogs/RSS feeds (formerly Current Awareness), Consumer Health/Patient Education, Informatics, Public Health/Disaster Preparedness, and Patient Safety. Citations marked $$ indicate availability via subscription or through a library.

Finding Australian Content in Healthcare: A Select List of Australian Internet Sites

Finding Australian content to support healthcare workers and researchers can be difficult. Here is a compilation of websites to access Australian healthcare information. The sites have been nominated by librarians as potentially useful for one of two reasons, they are an Australian organisation/service with a primary and explicit interest in evidence-based practice or they are a database which indexed Australian health literature.

New hypertension guidelines

The Heart Foundation has just released Guide to management of hypertension 2008.
The guidelines take a strong evidence-based approach, looking at the patient in a holistic and individual way. Doctors are instructed to take blood pressure with strict adherence to technique, using both arms and on several occasions and in different settings, before diagnosing hypertension.
Whether the patient should be medicated depends on their personal risk of a heart attack or stroke in the next five years, taking into account factors such as age, weight, family history and lifestyle. People with diabetes, existing heart or arterial disease, chronic kidney disease and a strong family history of high cholesterol or early heart problems should be on blood pressure medication even if their blood pressure readings are in the normal range.
Doctors are instructed to manage the lifestyle risk factors in all patients, whether or not their blood pressure is elevated.

Australian mental health journal free online

The Australian e-Journal for the Advancement of Mental Health is a forum for advancing promotion, prevention and early intervention (PPEI) approaches to mental health. It is a peer reviewed, online, open access journal supported by the Australian Department of Health and Ageing.

Volume 7, Issue 2, July 2008 has just been published and includes these articles:

• Guest editorial: Too important to ignore: Siblings of children with special needs : Kate Strohm
• Evaluation of a family-based intervention for siblings of children with a disability or chronic illness : Rebecca Giallo and Susana Gavidia-Payne
• The recovery journey: Employment support for people with depression and other mental illnesses : Ian Munro and Karen-Leigh Edward
• The response of children to the psychiatric hospitalisation of a family memberHarry J. Sivec, Patricia Masterson, Janice G. Katz and Sandra Russ

Mental health services in Australia 2005-06

A report on mental health services released today by the Australian Institute of Health and Welfare (AIHW) found that expenditure on state and territory mental health services as a whole increased on average by 5.2% per year (after adjusting for inflation) from 2001-02 to 2005-06, to $2.7 billion.
Mental health services in Australia 2005-06 is the ninth in the series of AIHW's comprehensive annual reports on the characteristics and activity of Australia's mental health services. Details from a wide range of data sources for the 2005-06 period are presented, together with changes over time. Information on mental health care provided by a range of services is detailed. Included are ambulatory services (such as community-based services, emergency departments, private psychiatrists, allied health professionals and general practitioners), hospital and residential services and other services (such as supported accommodation services) In addition, information is provided on mental health-related prescriptions and mental health resources such as facilities, workforce and expenditure. Where possible, comprehensive data are provided for each state and territory, and comparisons are made between population groups (including Indigenous and non-Indigenous Australians, and overseas-born and Australian-born people). This report is a useful resource for health planners, policy makers, administrators, practitioners, researchers and others with an interest in mental health in Australia.

Use your library to reduce information overload

The July 21 issue of the Medical Journal of Australia includes an article by Paul Glasziou entitled "Information overload : what's behind it, what's beyond it?" The sub-title is "Literature alert services, good evidence-based resources and real-time decision support can all help to reduce information overload". (MJA 189(2) : 84-85). You will need to log in to read the article, and register if you have not already done so, but it's free.

If you're reading this blog, you probably already know that your library can play a big part in freeing up the clinician's time by providing alert services, resources and support, honed into your specialised area. We see our job as filtering that huge burden of information into the relevant, the authoritative and the latest.

Impact of 'silent' osteoporosis on Australians

At least 600,000 Australians are affected by osteoporosis, a disease that causes bones to become fragile and weak and increasing the risk of fracture, according to a report released today by the Australian Institute of Health and Welfare and Osteoporosis Australia.

A 'silent' disease, osteoporosis usually shows no signs or symptoms, and so often goes undiagnosed until a fracture occurs. Osteoporosis affects mostly women and men of middle-age and older.

According to the report, A picture of osteoporosis in Australia, launched today by Minister for Ageing, Justine Elliott, at the Princess Alexandra Hospital in Brisbane, 1 in 2 women and 1 in 4 men over the age of 60 will suffer an osteoporotic fracture in their lifetime. 'These fractures may lead to chronic pain, activity restrictions, loss of independence and, sometimes, death,' said Dr Kuldeep Bhatia, Head of the AIHW's National Centre for Monitoring Arthritis and Musculoskeletal Conditions.

Weight loss diets - which ones are the most successful?

This is the sixty four dollar question for many of us! One of my favourite programs, ABC Radio National's Health Report, this week featured an interview with the author of a new study in Israel comparing the effectiveness of three diets: low fat, low carb and a Mediterranean diet which concentrated on olive oil, nuts and fish. The randomised trial looked at moderately obese 51 year olds over two years and the main discovery was that the low carb diet and the Mediterranean diet were much more efficient in weight loss than the low fat diet, although all the diets worked. They also found an improved lipid profile in those people on the low carb diet.

You can read the interview transcript on the Health Report website, and contact the library for a copy of the research paper: Shai I et al. "Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet." New England Journal of Medicine, July 17, 2008. 359(3) :229-241.

Household expenditure on health: A snapshot

For those of you interested in facts and figures, The Australian Bureau of Statistics has just released this report, which presents an overview of the health expenditure of households in Australia. It is based on data from the 2003–4 ABS Household Expenditure Survey and the 2004–5 ABS National Health Survey.

One of the results was that despite different incomes, households spend on average the same proportion (5%) of their disposable income on medical care and health expenses.

Healthcare associated infection - new report

Health care infection rates have hit the media in the last couple of weeks and now The Australian Commission on Safety and Quality in Health Care has released a report called Reducing harm to patients through healthcare associated infection : the role of surveillance. This report summarises the state of healthcare associated infections (HAI) in Australia and makes recommendations for reducing HAI through surveillance and prevention. The Commission reports that hospital infection rates could be halved if health workers simply washed their hands more regularly and more thoroughly. It has found that around 200,000 people each year are contracting infections within the healthcare system and two million extra bed days are occupied by patients because they have picked up healthcare associated infection. The total cost is about $20 million per year in this country.

Sources for Drug and Alcohol research

The National Drug and Alcohol Research Centre at UNSW has just published a really useful document called Searching the grey literature to access information on Drug and Alcohol Research : a resource to identify drug related databases and websites, by Bianca Calabria and a team of writers.
Grey literature is material that is not formally published by commercial publishers or peer reviewed journals. It includes reports, fact sheets, conference proceedings and other documents from institutions, organisations, and government agencies. It's often hidden away on the Internet and difficult to unearth, but can be extremely valuable. This document gives a comprehensive list of databases and websites where you can freely find information on this topic.

Living is for everyone - suicide prevention report

The Australian Department of Health and Ageing has just published the revised Living Is For Everyone (LiFe) : a framework for the prevention of suicide in Australia. This 52 page document provides updated information to mental health professionals and the wider community, and aims to enhance the understanding and prevention of suicide and self harm in Australia. Supporting resources, news, fact sheets and contacts for suicide prevention may be found at the LiFe website.

Searchme.com

Searchme is an intriguing new attempt to make web research more like how we look for information in print resources. Its search results page is intuitive, highly visual and yet easy for us text-oriented folks to use. Solely in terms of user-friendliness, Searchme is one of the best search engines around. It also does a surprisingly good job at clustering results, and it has a nice feature for easily sharing web pages with others. Note that this site is in public beta, meaning that it is not in its final version, and some features and functions may change without notice. And it has indexed “merely” one billion pages, so it’s working with a significantly smaller index than, say, Google, which hit the one-billion-page mark way back in 2000.
What is particularly impressive is the search results page. Think of holding a hand of cards – you see one card fully and the other cards in slices. Searchme’s search results page looks somewhat similar. In the middle of the page is an image of the first retrieved web page, with your search words highlighted. On the right is a smaller image of the next result. Drag that to the middle of the screen and the first page shuffles off to the left and a fresh page appears on the right. Double-click any image and you are taken directly to that page, either in the same window or, if you change your preferences, in a fresh window or tab.

Australian e-Health Research Centre

CSIRO today welcomed the launch of the Australian e-Health Research Centre (AEHRC) as a national venture, supported by A$20 million in funding from the Federal and Queensland governments.
Research undertaken at the AEHRC is leading to the development of simulated training tools (enabling colonoscopists, for instance, to become more skilled), home monitoring systems for patients recovering from heart attack, and improved imaging techniques to facilitate early diagnosis of Alzheimer's Disease. Established in 2003 as a joint venture between CSIRO and the Queensland Government, the AEHRC is a key delivery point into the health system for CSIRO health research based on information and communication technologies (ICT).

Patient information - where to look.

We are often asked for help with finding authoritative information for patients on a variety of health issues. I thought I’d share just a few of our favourite consumer health sites that you can reliably recommend to your clients. These ones are general in coverage.

HealthInsite is an Australian Government initiative, aimed at providing "up-to-date and quality assessed information on important health topics." It has a good A-Z listing of health topics with some information developed in-house as well as linking to other agencies.

MedlinePlus is provided by the US National Library of Medicine and the National Institutes for Health. There are searchable health topics in 40 languages, plus an online health encyclopaedia and dictionary. A bit US-centric, but very comprehensive.

Patient UK is a British consumer health site, set up and authored by doctors. "The authors write evidence based information leaflets on a wide range of medical and health topics. They also review health and illness related websites and link to many of these."

UpToDate for Patients has evidence-based literature on a wide range of health issues. Either search by keyword or narrow down through browsing. Well-referenced and free for everyone.

FamilyDoctor is from the American Academy of Family Physicians. Also worth a look.

Of course, there are many more reliable sites - I could go on for pages. Tell your clients they should look for government agencies, non-profit organisations and clinician-based sites, as a general rule of thumb.

Finally, if you're looking to print off a handout for a patient, you can find quite good ones (although US-based) on the clinical UpToDate site (which you have access to through the link on your desktop within NCAHS), or on MDConsult or Nursing Consult - both accessible through CIAP.

GreenFILE environmental database now free

Ebsco has recently made this database free to search. It focusses on the relationship between humans and the environment, covering topics such as global warming, recycling and alternate fuel sources. GreenFILE searches scholarly and general interest journals, as well as government documents and reports and connects the environment with other disciplines such as agriculture, education, law, health and technology. The total number of records is currently about 295,000, and full text is provided for more than 4,600 of these.

If you search the database and find an article or document you want to read that is not in full-text, please just email or phone us at your library and we will tirelessly track it down for you!

Competency Standards now available free online!

The 'Competency standards for the advanced registered nurse' and 'Competency standards for the advanced enrolled nurse' are now available free online at the Australian Nursing Federation website.
And the Australian Nursing and Midwifery Council Incorporated (ANMC) also has a number of Competency Standards free online, including those for the Nurse Practitioner and the Midwife.

Australia's Health 2008 Conference Presentations

How are we going? How do we know?
This one-day conference held in June, provided insights into key issues facing the health of Australians and their health services. Where we have come from, what's happening now and what's likely to happen in the future!
Specific areas covered on the day with PowerPoint presentations provided include-
Biggest burdens: Cancer survival and prevalence in Australia, Oral health priority areas, Mental health and co-morbidities, Co-morbidities between CVD, chronic kidney disease, diabetes and obesity .
Whose health - focus on inequalities: Health of Aboriginal and Torres Strait Islander peoples, Rural health, Socioeconomic Status , Waiting for care.
Prevention, treatment and performance: Information needs of the future, Australia's national cancer screening programs, Risk and prevention, Expenditure and projections

ARCHI - Connecting Clinicians

ARCHI likes to call itself the "brains trust of the healthcare centre". It's all about disseminating information about innovations from health care professionals across the community, and trying to prevent the reinvention of the wheel. It was originally set up by the Department of Health and Ageing in 1998, and has now been adopted by NSW Health as part of their commitment to knowledge sharing, and to support their Clinical Services Redesign Program.
You have access to everything on the site through your usual CIAP username and password (contact your librarian if you're not sure what this is). On the ARCHI website you can find a searchable electronic library of innovations, pathways, clinical tools and reports. There's also an enquiry service, a list of seminars, a newsletter and discussion groups to join. If you are working on, or have just completed, a project which has improved healthcare delivery, the ARCHI team would love to hear from you. Fill out a form on the website and share your knowledge!

Get Healthy: Your Middle-Aged Heart Will Thank You

Your diet isn't all that healthy, and you haven't been to the gym since who knows when. You can't shed those pesky 20 extra pounds, but what's the use, you may ask -- after all, you're well into middle age. To all that whining, Dr. Dana King would say: "It's not too late. If you make [healthy] changes now, it has a tremendous impact." Particularly on your heart. Even in middle age. King, a professor of family medicine at the Medical University of South Carolina, is one of several researchers who have proven in recent years that it's never too late to get healthy -- and that adopting better habits even in midlife translates to less disease and a longer life.
King led a recent study that evaluated the cardiovascular effects of adopting healthier habits in middle age -- what he calls the "turning back the clock study." And surprise! It works. What's more, you don't have to be fanatical, but the more healthy habits you adopt, not surprisingly, the healthier you become.

Australia's Health 2008

Australia is one of the healthiest nations in the world, taking great strides in many health areas-but there are groups whose health still lags behind, according to the Australian Institute of Health and Welfare's latest national report card on health. The report, Australia's Health 2008, launched yesterday by Health Minister Nicola Roxon at the 'Australia's Health 2008' conference in Canberra, shows falling death rates for cancer, heart disease, strokes, and injury.

The report also shows that Australians enjoy one of the highest life expectancies in the world-an average of 81.4 years, second only to Japan.
Australian men reaching the age of 65 can now expect to live to about 83 years, and women to 86 years-about 6 years more than their counterparts a century ago. Disadvantaged Australians, wherever they live, are more likely to have shorter lives, higher levels of disease risk factors and lower use of preventive health services.


The full report can be viewed online here.

Hard work ahead to fix public hospitals

The State of Our Public Hospitals Report 2008, released today and available at the Department of Health and Ageing highlights how much work lies ahead of us to deliver a better health and hospital system. While some results are encouraging, others show the scale of the challenge ahead, with public hospital admissions increasing faster than population growth.

Elective surgery statistics for each state and territory will also be made available today through the Commonwealth Department of Health and Ageing website. As part of the plan, states and territories will report on elective surgery performance in public hospitals through their websites, so that patients can make informed decisions about their own health care based on individual hospital results. To access this information click here.

How to find good Practice Guidelines

We are often asked to look for Practice Guidelines on a particular procedure and there are many good and authoritative databases you can search to find them. If you're looking for a one-stop shop, however, you could try the National Library of Guidelines site, which is produced by the NHS in the UK. You can search all the NHS guidelines here and they also provide great links to International Guidelines sites, such as the US National Guidelines Clearinghouse and our own NHMRC Guidelines. There's an absolute plethora of best practice in all these Guidelines - I recommend you have a good look.

The Evidence on Multiple Sclerosis

The Neurological Conditions Specialist Library in London has just completed an exhaustive, systematic search on Multiple Sclerosis "to identify all high level evidence published in the past two years, namely guidelines, systematic reviews, health technology assessments and economic evaluations". Leading experts in the UK have appraised and commented on the papers and you can find the results at the Library's site: www.library.nhs.uk/neurological

Elective surgery in Australia: new measures of access

Published this month by the Australian Institute of Health and Welfare, "this report presents a detailed picture of access to elective surgery services in Australia using combined admitted patient and elective surgery waiting times data." You can pay $28 for the print version, or read it here online.

The importance of the "doorknob encounter"

How often, in all our work situations, is a vital piece of information mentioned by the client in passing, or sometimes never stated at all? Perri Klass has written a small article in the latest New England Journal of Medicine, entitled "The Moral of the Story". It's all about a child presenting with vomiting and an ear infection and the consultant prescribing antibiotics and the mother pausing at the door as she's about to leave and just mentioning that the child had fallen down a set of stairs the day before. The moral of the story turns out to be that successful practice comprises "knowledge, judgement, experience and luck", with a healthy bit of thoughtful communication thrown in.

Premature ejaculation basics

This is the most common of all male sexual complaints. As health professionals, we know that most men are loath to talk about it, but it can be effectively treated. It's a consistent problem for about one in three men, although two in three men may be affected at some time in their lives. It's less common in older men, and most common in adolescents. If you'd like an overview on the condition, you can find a good precis by Peter Laville at ABC Health and WellBeing.

Videos of Surgical Procedures

MedlinePlus has a series of surgical procedure videos available on their website. These are educational videos, meant to help people understand what to expect when having a surgical or diagnostic procedure. The videos are all one-hour in length, and are in full colour. You can find a list of the videos and instructions on how to view them here.
The webcasts include procedures such as a Total Knee Replacement, Stenting and a Coronary Artery Bypass Graft.

Hand Washing Saves Lives!

A pilot study, advocated by the World Health Organisation, to assess the efficacy of a multimodal, centrally coordinated, multisite hand hygiene culture-change program (HHCCP) for reducing rates of methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia and disease was in Victorian hospitals. The pilot study and subsequent statewide implementation of a multimodal HHCCP was effective in significantly improving hand hygiene compliance and reducing rates of MRSA infection.

Register for free online access to MJA to read the full article, Significant reductions in methicillin-resistant Staphylococcus aureus bacteraemia and clinical isolates associated with a multisite, hand hygiene culture-change program and subsequent successful statewide roll-out by Grayson et al in the latest issue.

Alcohol and Cancer

There has been much media interest lately in a study released by the Cancer Institute of NSW last month, entitled Alcohol as a Cause of Cancer. This involves an international audit of cancer and alcohol research, pointing to the conclusion that over two alcoholic drinks per day for both men and women can increase the risk of some types of cancer. Read the report itself to get the full story.

Australia 2020 Summit - Final Report

The final report of the Australia 2020 summit has been released. Have a look at Chapter 5, A long term national health strategy. If you really want to see what went on at the summit, this site also contains all submissions and background papers, as well as some interesting images.

New Journals on CIAP

The NSW Health Quality and Safety Branch has sponsored two new infection control journals.
Journal of Hospital Infection
Includes articles on hospital-acquired infection and related subjects and puts you in contact with the latest concepts and practices in hospital infection control.
Infection Control and Hospital Epidemiology (ICHE)
Includes peer-reviewed scientific articles for anyone involved with an infection control or epidemiology program in a hospital or health care facility. ICHE publishes research on control and evaluation of the transmission of pathogens in healthcare institutions and on the use of epidemiological principles and methods to evaluate and improve the delivery of care.
Another key infection control journal available on CIAP is the American Journal of Infection Control

Nursing Consult now includes two new Australian Emergency Nursing journals providing clinically relevant research, reviews and articles of interest:
Australian Critical Care
Australasian Emergency Nursing Journal