Genitourinary Oncology Forum - In the March Issue of Cancer Forum

The March issue of Cancer Forum published by the Cancer Council Australia contains a forum on Genitourinary Oncology. The articles include : Multidisciplinary progress in research and treatment of genitourinary cancers; Advances in radiation therapy for prostate cancer; Major advances in surgical technique for the treatment of genitourinary cancer; Management of testicular cancer; Quality of life research in prostate and testicular cancer; Supportive care intervention in prostate cancer : recent advances and future challenges.

Health and wellbeing of young Australians

AIHW bulletin no. 77- This bulletin previews the reporting framework and key national indicators that will be the basis of the report Young Australians: their health and wellbeing 2011, scheduled for release in 2011. The bulletin presents 71 key national indicators, along with brief justifications explaining the relevance and importance of the indicators to young people's health and wellbeing. The indicators cover a broad range of areas of young people's health and wellbeing, including: morbidity, disability, mortality, health risk and protective factors, community, socioeconomic and environmental factors and measures of system performance. Download here.
The AIHW also released today a technical paper on operational definitions and data issues for key national indicators on the same topic.

Ahead of time: A practical guide for growing older with HIV - new booklet

Ahead of time: A practical guide for growing older with HIV is a new booklet developed by Australian Federation of AIDS Organisations (AFAO) and National Association of People Living with HIV/AIDS (NAPWA), in conjunction with ACON. This booklet includes up to date information about HIV and the ageing process that is relevant to the lives and health of people living with and growing older with HIV - so they can prepare and plan for their future health needs. The booklet also contains a comprehensive list of service providers’ contact details.
Click here to download booklet.
Click here to go to AFAO's website .
Click here to go to NAPWA's website.
Click here to go to ACON's website.

Better Access to Mental Health Services

The Minister for Health and Ageing, Nicola Roxon, said access to mental health services has improved according to a post-implementation review of a new initiative designed to improve access to psychiatrists, psychologists and general practitioners. The Better access to psychiatrists, psychologists and general practitioners through the Medicare Benefits Schedule (Better Access) program was introduced to improve support for patients with mental disorders. It covers 23 MBS items relating to mental health services provided by general practitioners, psychiatrists, clinical and general psychologists and appropriately trained social workers and occupational therapists. You can download the media release here.
The Department of Health and Aging gives an Overview of Medicare rebates available under the Better Access initiative as well as fact sheets on mental health skills training to download.

Warning Signs of Heart Attack

The Heart Foundation's Warning Signs of Heart Attack campaign aims to reduce coronary heart disease (CHD) mortality and morbidity by reducing patient delay in responding to the warning signs of heart attack and calling Triple Zero (000). A number of resources are available to download:
Heart attack warning signs - health professional fact sheet. Download
Will you recognise your heart attack? - patient fact sheet. Download
Will you recognise your heart attack? action plan for patients with CHD who have been prescribed angina medicine. Download
Checklist of important information to discuss with your patient and their family when you give them the fact sheet and action plan. Download
The Foundation also has Warning Signs of Heart Attack in other languages.

Diabetes: a pandemic, a development issue or both?

Every 5 seconds someone somewhere in the world is diagnosed with diabetes, and every 10 seconds someone dies of it. As a result of technical and clinical advances, and public health successes such as the lowering of national smoking rates, there has been a dramatic decline in mortality from cardiovascular disease in several developed countries over the past three to four decades. Regrettably, there is no parallel effect for diabetes, which continues to increase.
Ruth Colagiuri from the Menzies Centre for Health Policy has written a discussion paper on the extent of the diabetes problem, its implications for development and how these, and the human suffering it imposes, might most successfully be mitigated. The paper published in Expert Reviews can be viewed here.

Elder abuse – resource for community workers

Recognising, preventing and responding to abuse of older people living in the community: A resource for community care workers is a briefing been prepared by the Department of Social Work at The University of Melbourne in partnership with The Benevolent Society. Its aim is to distill evidence from research to guide care workers and managers in their day-to-day work with older people living in the community.

Abuse of an older person is defined by the World Health Organisation as any behaviour that causes physical, psychological, financial or social harm to an older person occurring within any relationship where there is an expectation of trust between the older person and the abuser. International estimates of the prevalence of abuse vary between two and a half percent to six percent of older people over 65 living in the community

International migration of health workers

This policy brief from the OECD provides new insights on recent migration trends for doctors and nurses up to 2008, and discusses the main causes and consequences for destination and origin countries, and presents possible policy responses.

In 2006, the World Health Organization estimated that there was a shortage of more than 4.3 million health personnel across the world. Low-income countries were particularly hard-hit by shortages: of the 57 countries with a critical shortage, 36 were sub-Saharan African countries.
There has been a debate over the effects of migration on these shortages, weighed against the individual rights of health personnel, but work jointly carried out by the OECD and WHO shows that the global health workforce crisis goes beyond the migration issue. The global economic crisis and events such as the A/H1N1 pandemic have recently increased the pressure on health systems and health personnel.

Risk factors and participation in work

This report builds on the previous AIHW report Chronic disease and participation in work by showing the association between risk factors and participation in work. In 2004-05, nearly all (96%) working-age people in Australia reported one health risk factor, and three-quarters reported more than one. People who reported three or more risk factors were significantly more likely to not participate in the labour force compared with those who reported no risk factors. Absentee rates for people who reported a risk factor and a chronic disease were significantly higher compared with people reporting no risk factors and no chronic disease. This report is a further reminder of the importance of reducing risk factor prevalence to lessen the impact of future chronic disease among working-age people. Download the report here.

Health IQ: Alzheimer's Disease

How much do you know about Alzheimer's disease and dementia? Test your health IQ to find out. Quiz.

Teaching Physicians to Provide Safe Patient Care

Ten years after the Institute of Medicine's landmark 1999 report 'To Err is Human', the Lucian Leape Institute at the National Patient Safety Foundation has released a white paper finding that US Medical Schools are not doing an adequate job of facilitating student understanding of basic knowledgeand the development of skills required for the provision of safe patient care.

The paper is the first in a planned series on issues identified as top priorities in ongoing efforts to improve patient safety. Download the full report (pdf) here.

Antidepressants for depression in physically ill people

Antidepressants are effective against depression in patients suffering from physical illnesses, according to a new systematic review by Cochrane researchers at King’s Health Partners Academic Health Sciences Centre in the UK. The researchers found the drugs were more effective than placebos at treating depression in these patients.
To read the full review, click here.

A Mentally Healthy Future for all Australians

The National Advisory Council on Mental Health has released a new discussion paper, A Mentally Healthy Future for all Australians. According to Health Minister Nicola Roxon, the discussion paper provides a vision and suggestions for a coordinated response to Australia’s mental health needs. It will assist in the Australian Government's consideration of broader health system reform, including a response to the National Health and Hospital Reform Commission, the Preventative Health Strategy and the Primary Health Care Strategy. The NACMH was established in 2008 following an election commitment to provide independent, balanced and expert advice to government on a variety of mental health issues.

Effects of 'ecstasy' use

The National Drug & Alcohol Research Centre has just published a report called, The health and psychological effects of "ecstasy" (MDMA) use. A number of possible consequences of ecstasy use are considered, and research needed to more definitively answer questions about whether ecstasy has adverse effects on health of type are identified and reviewed.

The report arose out of the increasing perception that there needed to be a summary of existing research on the epidemiology and possible effects of “ecstasy” (MDMA) use, given its increasing prevalence among young adults, and understandable concerns about studies reporting on various putative adverse consequences of this use.

Competencies for chronic disease practice

The Centers for Disease Control and Prevention (CDC) has published an article by Amy Slonim et al called "Designing Competencies for Chronic Disease Practice" (Prev Chronic Dis 2010: 7(2)). It describes a project of the US National Association of Chronic Disease Directors to develop a comprehensive set of competencies for public health practitioners working in chronic disease prevention and control, and the way knowledge and skills are used in this area of practice.

"The project yielded a framework with a categorization scheme and language that reflects how chronic disease practitioners view their work, including integrating communications and cultural competency skills into relevant job functions." This article is relevant to priority area 2 outlined in Australia’s first draft Primary Health Care Strategy ‘better management of chronic conditions’.

More money for training doctors

This week the Prime Minister announced that his government would "invest $632 million to train a record number of doctors - to tackle doctor shortages, expand capacity and deliver better health and better hospitals." Click here for the official media release.

There has been much commentary in the media about this over the last couple of days, but of particular interest to our own local area was a discussion on ABC Radio National's Breakfast show this morning. Host Fran Kelly and her guests Dr David Amies, Head of the Rural Clinical School at the University of New South Wales in Coffs Harbour and Michael Wilson executive director of NT General Practice Education, discussed the need for many of those new positions to be opened up in regions where there is an ongoing doctor shortage. They also noted the pressures on hospitals training more interns. You can listen or download this program here.

Cardiovascular medicines and primary health care - a regional analysis

This AIHW Report has just been released. It analyses the differences in the supply of cardiovascular medicines and primary health-care services differs across regions in Australia. It also examines the complex relationship between cardiovascular diseases, remoteness and the supply of cardiovascular medicines and primary health-care services.

The report found that CVD death and hospitalisation rates increased with increasing remoteness and that the age-standardised prevalence of CVD was significantly higher in inner regional areas than in major cities. The supply of cardiovascular medicines was generally higher in regional areas, reflecting the poorer cardiovascular health outside major cities, but this pattern did not apply to serum-lipid-reducing agents, such as cholesterol-lowering medicines, where the supply decreased with increasing remoteness.

Questionnaires - how to increase response rate

The Cochrane Library has published a systematic review this month called Methods to increase response to postal and electronic questionnaires. The Cochrane group, led by Philip Edwards, found over 400 trials relevant to the topic, which included over 100 different suggestions for increasing the response rate.

"Postal and electronic questionnaires are a relatively inexpensive way to collect information from people for research purposes. If people do not reply (so called 'non-responders'), the research results will tend to be less accurate." Monetary incentive almost doubled the response on average, and other ways to increase response included contacting people before they are sent the questionnaire, providing a stamped-return envelope and follow-up reminders.

Older people and the health care system

The Australian Journal of Nursing has published an article by Moira Greaves et al, called, "The experience of socially isolated older people in accessing and navigating the health care system." It reports findings from a study exploring the challenges experienced by socially isolated and unwell older people as they attempted to access the health care system. The authors conclude that an understanding of the specific issues confronting these individuals would inform the development of more appropriate models of community-based aged care. Fear, an unwillingness to be dependent on others and lack of public transport to make medical appointments, were among the factors inhibiting this group from accessing health services.

National health reform and the NSW Government

State governments have all had a chance to comment on the federal government's proposed health reforms. Read the NSW Government's discussion paper, National Health Reform : discussion paper on the federal government's proposal for a national health and hospitals network for Australia's future.

The NSW government is asking for feedback and discussion on the proposals, especially from professionals working in the health system. Comments provided on this consultation forum will be incorporated into the NSW response to the reforms. There are 4 main discussion areas :Who pays for what? ; How will our hospitals be managed? ; Standards and performance, and Regional and Rural Hospitals. "We need to ensure whatever funding formula the Commonwealth decides on, it looks after our smaller, rural and regional hospitals where activity can be low. This is an important consideration when an ‘activity-based’ funding model is being proposed. Hospitals with higher patient throughput could receive significantly more funding than hospitals with fewer patients."

Osteoporotic Hip Fracture in Australia

The incidence of hip fractures among older Australians declined consistently between 1997-98 and 2006-07, but more so for women than men, according to the Australian Institute of Health and Welfare report, The problem of osteoporotic hip fracture in Australia. Over the ten year period, the incidence rate for osteoporotic hip fracture decreased by 14% for men and by 20% for women. Aboriginal and Torres Strait Islander people were more likely than their non-Indigenous counterparts to be hospitalised for an osteoporotic hip fracture. They were also, on average, much younger at the time of their hip fracture. (From: NRHA eforum - 9th March 2010)

Medical Education Study

The Australian Medical Education Study has now been released. The synthesis report "What makes for success in medical education?" and associated documents are now available as internet only documents.

The Study undertook a systematic examination of critical education factors contributing to the outcomes of undergraduate medical education in Australia, in terms of how it prepares graduates for their work as interns and how it meets the requirements of postgraduate training for future medical careers. There was also consideration of how undergraduate clinical training contributes to these outcomes, in terms of the effectiveness of different models of clinical education. Associated documents are also available. (NRHA eforum - 9th March 2010)

National Health and Hospitals Network

The Prime Minister, Kevin Rudd, and the Health Minister, Nicola Roxon, yesterday launched their plans for a nationalisation of health in Australia. The National Health and Hospitals Network "will deliver better hospitals by establishing a national hospital network, funded nationally and run locally. This is the most significant reform to our nation’s health system since the introduction of Medicare."

The YourHealth website has all the details, including a link to the full report.

Australian Clinical Practice Guidelines Portal

A new national Clinical Practice Guidelines Portal has been launched by the NHMRC's National Institute of Clinical Studies. It will provide links to current Australian guidelines developed by governments, professional colleges, specialty societies and non-government agencies.
It aims to be a ‘one stop shop’ for clinicians, researchers, policy makers and consumers to access guidelines developed during the preceding five years for use in the Australian health care system. "Each guideline on this portal has been assessed according to rigorous selection criteria" and you can search by condition, date, funder, life stage, or across all guidelines.

There is also a national clinical practice Guidelines in Development Register which contains information about clinical practice guidelines that are planned or currently being developed in Australia. "It has been designed to help Australian guideline developers promote their work and get in touch with other guideline developers; it will provide information to help policy-makers and others better co-ordinate guideline development activities in Australia."

Ovarian cancer - two reports

The AIHW has just released the report: Ovarian Cancer in Australia : an overview 2010. In 2006, ovarian cancer was the most common cause of gynaecological cancer death and the sixth most common cause of cancer-related death among women. Although the prognosis was relatively poor compared with a number of other cancers, it has improved over time. These and other data in this report provide a comprehensive picture of ovarian cancer in Australia including how ovarian cancer rates differ by various socioeconomic factors.

The Health Report on ABC's Radio National this week featured ovarian cancer research. The high mortality rate of ovarian cancer is partially due to the fact that it is often not diagnosed until it's in the advanced stage and has spread. This program examines new research into ways to diagnose the disease and screen for it in order to save lives, and how this often comes at a high cost. Read the transcript or podcast the program on their website. This week also had a look at the relationship between breast cancer and some chemicals.

Dengue fever - background and research

Dengue fever was the topic of a recent episode of ABC radio's Background Briefing. The current outbreak in northern Queensland represents a tripling of the number of cases presenting in Australia over the past three years. This is a fascinating look at the history of mosquito-borne diseases and the current research being undertaken. It seems that mosquitoes don't serve much purpose in the ecosystem other than to propagate themselves and annoy humans.

You can read the transcript or podcast the audio at this website.

Arthritis and osteoporosis medication report

The AIHW has recently released Medication Use for Arthritis and Osteoporosis, a report which looks at the medicines central to managing arthritis and osteoporosis - to improve musculoskeletal functions, slow disease progression and reduce pain and inflammation. Pharmaceutical innovations over the last several years have improved the efficacy and diversity these medicines, but the adoption of new and more effective drugs is often costly. This report provides information on what medicines Australians are using to manage their musculoskeletal problems, how much these medicines cost them and trends in the prescription of newer medicines.