National E-Health Strategy summary

This report has emerged from the Australian Health Ministers' Conference in December. It provides a vision and strategy for the future of health information in this country.

"The World Health Organisation defines E-Health as ‘the combined use of electronic
communication and information technology in the health sector.’ In more practical terms,
E-Health is the means of ensuring that the right health information is provided to the right
person at the right place and time in a secure, electronic form for the purpose of optimising
the quality and efficiency of health care delivery. E-Health should be viewed as both the
essential infrastructure underpinning information exchange between all participants in the
Australian health care system and as a key enabler and driver of improved health outcomes
for all Australians." (Introduction).

World Health Organization: Tropical Diseases

World Health Organization: Tropical Diseases
http://www.who.int/topics/tropical_diseases/en/

This World Health Organization website feature focuses on tropical diseases.
For visitors unfamiliar with which diseases out there are considered tropical, this website provides informative fact sheets on fourteen different tropical diseases. To view the factsheets, visitors should click on "Fact Sheets on Tropical Diseases", under the General Information heading near the top of the homepage. The fact sheets cover topics such as "Symptoms", "Transmission", "Treatment", "Prevention", "Economic Cost", and "Diagnosis". Under the "Multimedia" heading near the top of the homepage, visitors can click on the link "10 Facts on Neglected Tropical Diseases", to be taken to a slide show, via the link near the bottom of the page entitled "Read More About Neglected Tropical Diseases". The slide show explains that a neglected tropical disease is a disease that costs little to prevent, does not spread to wealthy areas and is of little priority to pharmaceutical companies when it comes to research and development of medicines for them.
Under the Statistics heading near the bottom of the homepage, visitors can click on a link to get to the "Global Health Database", which contains "standardized data and statistics for infectious diseases at country, regional, and global levels." [KMG]
(From: The Scout Report -- February 20, 2009)

Bushfires and continuing health effects

The recent devastating fires in Victoria have given rise to some useful publications on the after-effects of these disasters.
- After the fire, other health concerns, from the ABC, is a good summary of what fire-ravaged communities can continue to experience.
- The Australasian Fire and Emergency Service Authorities Council has published a detailed leaflet called Bushfire Smoke & Public Health which addresses in detail what to expect when exposed to smoke inhalation. Some really good further references here as well.
- The Australian Psychological Society has good information on helping people suffering from distress after the fires, especially children.

Explaining different health reform options

It seems that everyone agrees that Australia needs to review it's health policy and the systems that drive it, but just how to go about that is extremely controversial. The Australian Parliament has just published a background paper which takes each of the most recent reform models suggested and explains their structure, differences, potential benefits and criticisms.

Options for Reforming Australia's Health System is a very useful tool for sifting out all this information and making sense of the conversation this country is having on health reform and policy.

A Healthier future for Australians

This Interim Report has just been published by the National Health and Hospitals Reform Commission. The Commission was appointed in early 2008. with the aim to report on long-term reform for the Australian health care system and it has come up with 116 proposals to be debated ahead of a final report to the government in June.

"Australia is not alone in tackling health system reform; most nations are facing similar challenges. While we agree that significant changes are needed to meet these challenges, we also recognise that our health system has many strengths upon which we can build." The Commission is focussing on people taking responsibility for their own good health, the integration of different types of health services, tackling inequalities and ensuring quality care.

Specific recommendations include a Commonwealth takeover of state hospitals and an increased role for nurse practitioners in remote areas of the country.

Pathways to schizophrenia.

The latest issue of Medical Journal of Australia has released a 48 page supplement focusing on new approaches to schizophrenia treatment, research and policy that can provide a substantive basis for early intervention and better care. You can access the journal via the CIAP online journals link.
There are also a few other articles relating to mental health in this issue inlcuding: 'Prevalence of metabolic syndrome among Australians with severe mental illness' and 'The Medical Care of People with Psychosis'.

Living Well with Chronic Heart Failure

The Heart Foundation has released a 2 page booklet 'Living Well with Chronic Heart Failure" in English and 16 other languages. As well as the 2 page information sheet, you can also download sections such as Lifestyle Issues, Medicines, Symptoms etc separately. On the same page, 'Guidelines for the prevention, detection and management of chronic heart failure in Australia (2006)' and 'Guidelines (quick reference guide) for the prevention, detection and management of chronic heart failure in Australia (2006)' are freely available to download.

February is Ovarian Cancer Australia's Awareness Month

Every woman needs to know the symptoms of ovarian cancer. Ovarian Cancer Australia focuses on promoting awareness of ovarian cancer and its symptoms in the community; providing support and resources to women and their networks affected by ovarian cancer and providing a platform for women with ovarian cancer to share their experiences and campaigning on their behalf to enhance the outlook for ovarian cancer patients through improved diagnosis, care and treatment. Check out the links to Awareness and Patients Corner on the website.

EPOC publishes Cochrane Reviews

The Australian satellite of the Cochrane Effective Practice and Organisation of Care (EPOC) group was established to inform evidence-based policy-making and evidence based implementation in Australia. Based at NICS, EPOC is funded by the Australian Government and is a partnership between the Cochrane EPOC Group and the National Health and Medical Research Council (NHMRC). On January 21, the following three new reviews and three updates were published by EPOC in Issue 1, 2009 of The Cochrane Library:
New reviews
1) Gagnon M-P, Légaré F, Labrecque M, Frémont P, Pluye P, Gagnon J, Car J, Pagliari C, Desmartis M, Turcot L, Gravel K. Interventions for promoting information and communication technologies adoption in healthcare professionals.
2) Grobler L, Marais BJ, Mabunda S, Marindi P, Reuter H, Volmink J. Interventions for increasing the proportion of health professionals practising in rural and other underserved areas. 3) Koehlmoos TP, Gazi R, Hossain SS, Zaman K. The effect of social franchising on access to and quality of health services in low- and middle-income countries.
Updated reviews
4) Harkness EF, Bower PJ. On-site mental health workers delivering psychological therapy and psychosocial interventions to patients in primary care: effects on the professional practice of primary care providers.5) Shepperd S, Doll H, Broad J, Gladman J, Iliffe S, Langhorne P, Richards S. Early discharge hospital at home. 6) Urquhart C, Currell R, Grant MJ, Hardiker NR. Nursing record systems: effects on nursing practice and health care outcomes.
All reviews are available at: http://www.thecochranelibrary.com or via the CIAP database under Evidence Based Practice.

A cure for NSW hospitals?

Radical surgery: The only cure for NSW Hospitals is the title of a paper just published by Wolfgang Kasper through The Centre for Independent Studies
Kasper argues that "NSW public hospitals are plagued by massive systemic failures, as diagnosed in the Garling report. At the same time, hospital costs are blowing out, and may yet bankrupt the NSW budget despite a massive federal bailout under the COAG agreement. The situation requires dramatic and fundamental changes to hospital management—not additional layers of bureaucratic control or more federal subsidies."
His recommendations include autonomy and diversity for individual hospitals, a liberation from bureaucracy and the instigation of a revenue for services system, involving bed vouchers.

Medpedia project aims to create an online encyclopedia of health info

Internet entrepreneurs are teaming up with physicians, researchers, and other medical professionals to create the Web's largest body of health information called Medpedia.
According to the Los Angeles Times, the site is modeled after the online encyclopedia Wikipedia(www.wikipedia.com), but articles are written and edited only by trained professionals.

The Medpedia project with gather knowledge usually confined to academic circles but make it understandable and available to consumers. The web site will officially launch in the coming months. A preview of the site can be found at www.medpedia.com

BMJ - Doctors, Patients and the drug industry

A report from the Royal College of Physicians calls for a rethink of the relationship between the medical community and the pharma industry. This means saying no to gifts and hospitality, ensuring that research and clinical collaborations are transparent and unbiased in their design and reporting, refusing to be a guest or ghost author, declining the role of paid opinion leader, paying our way for information and education, and refusing industry support unless it is entirely transparent and in patients’ or the public’s best interests. A few of the articles in the latest issue of the BMJ include:
* Individual drug firms should stop paying for medical education
* More regulation, greater transparency
Remember to use the CIAP site under Online Journals to access the BMJ. Ask your hospital Librarian for a login and pw if you don't have one.

Chronic disease and participation in work

With the Australian population ageing and experiencing increasing rates of some risk factors such as obesity, chronic disease prevalence is on the rise. Chronic disease can result in functional limitation and disability associated with ill health. As a result, people with chronic disease may be limited in their ability to participate fully in the workforce. For this report, the 2004-05 National Health Survey has been used to assess the association between selected chronic diseases and workforce participation and absenteeism from work. The report also includes an estimate of the loss to the workforce due to death from selected chronic diseases. This report is a timely reminder of the cost of chronic disease to both the community and economy and provides further evidence for national action to prevent chronic disease.

Health challenges for the near future

In her paper, Healthy societies : addressing 21st Century health challenges, Professor Ilona Kickbusch argues that we are at a turning point in health policy and that changes in the existing health care system will not be sufficient to maintain and improve our health. Both our extensive knowledge about what creates health, as well as the exponentially rising rates of chronic disease, obesity and mental health problems, indicate that we need to shift course and apply a radically new mindset. Although primarily directed at South Australia, the report has national and international relevance.

Professor Kickbusch is one of the world's leading experts on public health, health promotion and global paper. This paper follows her stay in Adelaide on the Government of South Australia's Thinker in Residence program.

Journal Watch

Journal Watch is a weekly publication from the University of Oxford's Department of Primary Care. Calling itself "a lighthearted review of the leading medical journals", it is a really useful summary of the latest offerings from journals such as JAMA, BMJ, NEJM, The Lancet and other such general medical journals. If you want to keep up with published research in a broad range of medical fields it might be worth checking this site on a regular basis.

The Health of the people of New South Wales. Report of the Chief Health Officer

This report provides key information on the status of the health of our community, current challenges, emerging health priorities, inequities and trends in these factors. It provides information to all those working to improve health on the effectiveness of their programs. The electronic report or e-CHO, which is an interactive web-based report providing graphs and complete data tables and explanatory text on over 400 population health indicators, as well as files for each indicator which can be downloaded by users for free.

We now know that a child born in 2006 would now expect to live 79.3 years if male and 84.2 years if female, an increase of just under 3 years since 1997. Australian longevity was third only to Japan and Switzerland in 2006. However, our population is also subject to a heavy burden of disease. These diseases include, in order of burden, cancer, cardiovascular diseases, mental disorders, neurological disorders, injuries, respiratory diseases and diabetes. Together these diseases constitute just over 80% of all disease burden in our community.

Childhood Obesity focus in MJA

The latest Medical Journal of Australia has been published online and includes a number of articles on the issue of childhood obesity:
1. When does severe childhood obesity become a child protection issue? by Shirley M Alexander, Louise A Baur, Roger Magnusson and Bernadette Tobin.
2. Individual rights over public good? The future of anthropometric monitoring of school children in the fight against obesity, byJoanne M Stubbs and Helen M Achat.
3. Childhood obesity in Australia remains a widespread health concern that warrants population-wide prevention programs, by Timothy P Gill etal.

Measuring the social and emotional wellbeing of Aboriginal and Torres Strait Islander peoples

The Australian Institute of Health and Welfare released a new report on Friday: Measuring the social and emotional wellbeing of Aboriginal and Torres Strait Islander peoples provides a picture of the social and emotional wellbeing of Indigenous Australians using data from the 2004-05 National Aboriginal and Torres Strait Islander Health Survey (NATSIHS) and a range of administrative datasets. The report also assesses the interim module that was developed to measure social and emotional wellbeing used in the 2004-05 NATSIHS, and makes a number of recommendations to improve measures of social and emotional well-being.
This report is a useful resource for policy makers, administrators of programs and researchers with an interest in issues affecting Aboriginal and Torres Strait Islander peoples.

Terminal Dehydration: The Experience and Perceptions of End-Of-Life Palliative Care Nutrition and Hydration

Most palliative care patients, at the end-of-life, will have a significantly decreased food or drink intake, if any at all. Such cessation can be due to lack of energy, anorexia, dysphasia or nausea and this absence of nutrition leads to isotonic dehydration: the loss of salt and water from the body. Whilst potentially distressing for the families and health professionals, isotonic dehydration can be beneficial for the patient. To discuss the reactions and perceptions of families and health professionals to medically administered nutrition and hydration, Dr Pamela van der Riet talked with Hamish Holewa for IPP-SHR podcasts. Noted were benefits associated with reduced issues with fluids, less incontinence and vomiting and some documentation relating to decreased pain. Despite such benefits, decreasing of medically administered hydration and nutrition to a palliative patient can be distressing to the family. Education, open discussion and a team approach for staff in acute care and families, as well as basic care for the patient, was seen as very important in easing the experience and burden on all in palliative care. Visit Podcast page with transcription and additional details.