Barriers to effective cancer care coordination

"What are the current barriers to effective cancer care coordination? A qualitative study." by Jennifer Walsh et al, has been published as an open access article in BMC Health Services Research 2010, 10:132.

This Australian study explored patients’ experiences and views of cancer care coordination, including the views of patients treated for a range of cancers, their carers and health professionals involved in providing cancer care. This is timely, given that there has been a focus by the states and the Australian Government on improving care coordination for patients with a range of chronic diseases. The findings can inform improved development and evaluation of interventions.

The six aspects of care serving as barriers to effective care were identified as: recognising health professional roles and responsibilities, implementing comprehensive multidisciplinary team meetings, transitioning of care: falling through the cracks, inadequate communication between specialist and primary care, inequitable access to health services and managing scarce resources.

Guidelines for the treatment of alcohol problems

The Australian Department of Health and Ageing has released Guidelines for the Treatment of Alcohol Problems which provides up-to-date, evidence-based information to clinicians on treatments for people with alcohol problems. "The guidelines are directed to the broad range of health care professionals who treat people with these problems, including primary care (general practitioners, nurses), specialist medical practitioners, psychologists and other counsellors, and other health professionals. As all forms of treatment will not be readily available or suitable for all populations or settings these guidelines may require interpretation and adaptation."

A Quick Reference Guide is also provided to summarise information on assessment, brief interventions, withdrawal management, and post-withdrawal interventions for dependent drinkers.

Diabetes updates

ABC Radio National's Health Report this week focussed on three new diabetes studies. The first looked at an additional test for diagnosing diabetes or its risk. It is called glycated haemoglobin and is a reliable reflection of your sugar levels over the past three months. It is more expensive than the standard sugar level test, but does not require fasting and is very reliable.

The second story looks at Canadian research which suggests that vitamin B supplements are bad for your kidneys if they've been damaged by diabetes, and the third story is located in India, where there's a growing epidemic of adult onset or type 2 diabetes in that country. However, it isn't linked to obesity.

Download the podcast, listen to the program or read the transcript here.

Child mortaility studies

The Lancet has recently published two articles concerning global child mortality. Global, regional, and national causes of child mortality in 2008: a systematic analysis by Robert E. Black, et al looks at new estimates for 2008 of the major causes of death in children younger than 5 years. Of the estimated 8·795 million deaths in children younger than 5 years worldwide in 2008, infectious diseases caused 68% (5·970 million), with the largest percentages due to pneumonia. 49% (4·294 million) of child deaths occurred in five countries: India, Nigeria, Democratic Republic of the Congo, Pakistan, and China. [doi:10.1016/S0140-6736(10)60549-1].

The other article is by Julie Knoll Rajaratnam et al, Neonatal, postneonatal, childhood, and under-5 mortality for 187 countries, 1970—2010: a systematic analysis of progress towards Millennium Development Goal 4. Previous assessments have suggested that less than a quarter of countries are on track to achieve MDG 4, which calls for a two-thirds reduction in mortality in children younger than 5 years between 1990 and 2015. This study, however, found that worldwide mortality in children younger than 5 years has dropped from 11·9 million deaths in 1990 to 7·7 million deaths in 2010. Across 21 regions of the world, rates of neonatal, postneonatal, and childhood mortality are declining. [doi:10.1016/S0140-6736(10)60703-9].

Contact your Library if you are unable to access the fulltext of these articles.

Library and Information Week

This is a special week for us as we celebrate Library & Information Week 2010. The theme for this year is 'Libraries...access all areas'. It's a chance for us to remind all our clients that libraries connect people to ideas and show our commitment to promoting the free flow of information and facilitating access to recorded knowledge. We access information through databases. print and electronic resources, consultation and reference services and our clients can use us for a plethora of reasons.

Drop into your library this week and find out what treasures are there just for you.

Cervical Screening in Australia 2007-2008

This data report released today by the Australian Institute of Health and Welfare (AIHW) uses the previous definition of performance indicators, and supplies up to date data, but with no commentary. A full report using the new definitions of performance indicators (for 2008-2009) will follow.

More Answers for Doctors on Genetic Tests

Australian health professionals and the general public will benefit from Medical Genetic Testing: Information for Health Professionals released by the National Health and Medical Research Council (NHMRC). The purpose of this publication is to provide a source of information for use by those involved in genetic testing. It supports the health professional in: assisting patients when considering genetic testing ; ordering the appropriate genetic test ; interpreting its result in the context of clinical decision making; and providing follow-up care and support to the patient and family. In addition to addressing technical issues of test utilisation and performance, the paper highlights various ethical, legal and social issues resulting from genetic testing.

Caring for Older Australians : Issues Paper

On 21st May 2010, the Minister for Ageing, Justine Elliot welcomed the release of an issues paper by the Productivity Commission for its public inquiry into the future of Australia's Aged Care system. This issues paper is intended to assist those preparing a submission to the Commission. It covers a range of issues on which the Commission is seeking information and feedback.


To ensure due consideration of your input your submission should reach the Commission by Friday 30 July 2010.

Australian Asthma Reports

The Australian Institute of Health and Welfare has released two new reports today:
Asthma among older people in Australia
Over 92% of the 402 asthma deaths in 2006 were among people aged 45 years and over. Asthma in older Australians is distinct in many ways. The presence of comorbid conditions makes the management of asthma in older people more complex. The disease itself is also more persistent and severe than in the younger ages. Click on the link to view the media release and report.
Asthma, chronic obstructive pulmonary disease and other respiratory diseases in Australia
In 2004-05, Australia spent $3.3 billion directly on the management of respiratory conditions. In 2007-08, general practitioners managed respiratory problems more than any other condition and in 2006 conditions of the respiratory system were the third most common underlying causes of death. This report presents the epidemiology of each of the main respiratory conditions and highlights their differences and similarities. The conditions addressed include asthma, chronic obstructive pulmonary disease, allergic rhinitis, chronic sinusitis, influenza, pneumonia, bronchiectasis, cystic fibrosis, pneumoconiosis and sleep apnoea.
Click on the link to view the media release and report.

New Cochrane Reviews

May, 2010 Cochrane reviews cover a diverse range of subjects - key studies released this month include;

A Safer Alternative to Laser Eye Surgery?

Schizophrenia: Regular Exercise Guidelines Still Apply

Caffeine Reduces Mistakes Made By Shift Workers

Aggressive Approach to Childhood Cancer Worth Risks, Review Finds

Clinical Practice Guideline Portal

As a result of the recent paper "Australian clinical practice guidelines - a National study" by Heather A Buchan, Kay C Currie, Emma J Lourey and Geraint R Duggan, the new NHMRC Clinical Practice Guidelines Portal has been developed, along with the establishment of a national Guidelines in Development Register.
On the portal you will find links to clinical practice guidelines developed for use in Australian health care settings and each guideline has been assessed according to rigorous selection criteria. The site provides direct links to guidelines or to guideline developer websites. The majority of guidelines we link to are freely available, however in a few instances payment is required.

Australian Clinical Guidelines – A National Study

An NHMRC team has recently published in the Medical Journal of Australia (3 May 2010) on the outcomes of a national study of clinical practice guidelines. The study examines the number of clinical practice guidelines existing in Australia, and the key characteristics of these guidelines.

Australian clinical practice guidelines - a National study Heather A Buchan, Kay C Currie, Emma J Lourey and Geraint R Duggan. Download the paper here.

Hear us: Inquiry into hearing health in Australia

Hearing health is a mainstream health issue which touches the lives of most Australians in one way or another, yet as a public health issue it is not ranked as a national health priority. Australians with hearing loss must live with the paradox that their disability is so prevalent in our community, and yet suffers from a generally low level of awareness and understanding.
The report "Hear Us" gives the message to a hearing society from people with a hearing loss who live the terrible isolation and frustration that is often their daily lot. It is the message to governments and funding bodies from the many volunteer support and representative groups who advocate to improve the lives of people with a hearing impairment. It is the message to program administrators from hearing health practitioners working within systems that need an overhaul. It is the message from researchers striving to advance our understanding of the causes of hearing loss, and the technologies that can improve the lives of future generations. It is the message from Indigenous Australians, for many of whom hearing loss is so pervasive it has become a normal and accepted part of growing up. Online report.

Venous Thromboembolism Prophylaxis: The role of the nurse in changing practice and saving lives.

Venous thromboembolism (VTE) predominantly afflicts surgical and medical patients in an acute hospital setting. Nurses who are committed to VTE risk assessment and prophylaxis have the ability to contribute significantly to the reduction of VTE and its subsequent complications. See the full article published in Australian Journal of Advanced Nursing online.

World Health Statistics 2010

World Health Statistics 2010 contains WHO's annual compilation of data from its 193 Member States, and includes a summary of progress towards the health-related Millennium Development Goals and targets.

The report looks at national statistics in nine areas: mortality and burden of disease; cause-specific mortality and morbidity; selected infectious diseases; health service coverage; risk factors; health workforce, infrastructure and essential medicines; health expenditure; health inequities; and demographic and socioeconomic statistics.


While child mortality is continuing to decline globally, the report highlights some considerable inequities, "The greatest reductions in child mortality have been recorded among the wealthiest households and in urban areas. Concerted efforts will be needed to achieve the MDG target of a 67% reduction from 1990 levels by the year 2015, especially in countries facing economic crises or conflicts."

The Budget and health implications

Last week the Australian Government handed down the Budget for 2010-11, which included the package: "A National Health and Hospital's Network for Australia's Future". Read all about the breakdown of the additional $2.2 million which has been set aside for health in the budget and divided into:

• $772 million to improve access to General Practitioners (GPs) and primary health care


• $523 million in training and supporting Australia's nurses


• $467 million to modernise our health and hospital system


• $400 million to drive efficiency and high performance

In the interest of balance, you can read Tony Abbott's response to the budget here, one of the comments he makes being: "The Coalition will spend more on health but only where we’re certain that extra spending will produce extra services. Improved Medicare rebates, for instance, would be a better way than phantom clinics to deliver improved primary care."

Medical Indemnity Claims in Australia 2006-07

The Australian Institute of Health and Welfare has released a report (internet only) titled Public and private sector medical indemnity in Australia 2006-07 a summary. The report presents data from the combined Medicare Indemnity National Collection of public and private sector claims. Data on claims that were current at any time over the period of 1 July 2006 to 30 June 2007 are included. The report includes thecircumstances that gave rise to claims and the length of time they have been open. AIHW catalogue number (HSE 86).

Acute Pain Management - guidelines and evidence

The third edition of the ANZ College of Anaesthetists and Faculty of Pain Medicine's guidelines, Acute Pain Management : scientific evidence, has just been published by the NHMRC. It summarises the evidence currently available to assist health professionals in the management of acute pain. "The aim of the document is, as with the first two editions, to combine a review of the best available evidence for acute pain management with current clinical and expert practice, rather than to formulate specific clinical practice recommendations."

Also published by the NHMRC in 2006 was Managing acute pain : a guide for patients, which remains the current edition and accompanies the guidelines.

Heart health and nutrition

The Heart Foundation has published its latest report on cardiovascular health and nutrition: Summary of evidence : Antioxidants in food, drinks and supplements for cardiovascular health. The main recommendations for Australian adults are:

1. Consume at least two serves of fruit and five serves of vegetables every day.
2. As part of a healthy balanced diet, drink black or green tea or cocoa made from raw cocoa powder (without sugar and with low fat milk).

Normal chocolate, red wine and antioxident supplements are not recommended for improving cardiovascular health.

Professional roles in health care

The Health Foundation in the UK has published a report by Miranda Laurant and others called, Revision of professional roles and quality improvement : A review of the evidence. The report looks at the impact of professional role revision on quality of care and outcomes, focusing on the revision of roles between doctors and advanced practice nurses such as nurse practitioners, specialist nurses, clinical nurses and practice nurses, as well as physician assistants, pharmacists and allied healthcare professionals.

The authors found "that there is no detrimental effect of revising or extending the roles of non-medical professionals, and in some cases there is a positive effect on the quality of patient care. Gains in service efficiency may be achieved if doctors stop providing the services that are transferred to other health professionals and instead invest their time in activities that they alone can perform."

Health Promotion website

VicHealth has a useful page on its website called Evidence & evaluation for health promotion and disease prevention. It aims "to support the health promotion and disease prevention workforce to make better use of the evidence and to improve how programs/interventions are evaluated." The site includes:

• Evaluation tools
• Practice guidelines
• Syntheses of research
• Cost effectiveness studies and
• Links to selected external sources of evidence.

Gynaecological Cancer Projections 2010 - 2015

The Australian Institute of Health and Welfare has released a report (on the internet only) which provides information on the projected incidence of gynaecological cancers for the calendar years 2010 to 2015, by state and territory and at the national level. The purpose of the data is to help inform the national gynaecological cancers service delivery and resource framework. This document will provide information on the predicted incidence of gynaecological cancers and how the workforce is best able to meet the future service delivery requirements of women affected by gynecological cancers. (AIHW catalogue number (CAN 49) 10 May, 2010)

Autism Spectrum Disorder (ASD)

The New Zealand Guidelines Group has been working on a set of web-based services that assist people who might be concerned that a person they know has ASD, or who are in the process of referring a person for specialist assessment. This web service is now available at www.nzgg.org.nz/asd. It contains:

• printable summaries about recognising ASD, and referring for specialist assessment
  video tutorials powerpoint presentations that may be saved and used


• a professional self-test that can be used for the accumulation of continuing medical or nursing education


• order-form for quick reference cards


• links to relevant sites from the partners who helped with the development of the web-service.

Clinical Handover Program

Clinical Handover refers to the transfer of professional responsibility and accountability for some or all aspects of care for a patient, or group of patients, to another person or professional group on a temporary or permanent basis.The purpose of this program is to identify, develop and improve clinical handover communication. Safe health care delivery for patients depends on effective communication between health care providers. Developing and implementing more consistent and reliable approaches to clinical handover is a key strategy to reduce communication errors. The Clinical Handover program looks at the improvement of handover communication across a range of settings of care - including public and private hospitals and primary and ambulatory care settings. The Australian Commission on Safety and Quality in Health Care links to a number of guides, presentations and tool on the Clinical Handover site.

National strategies for blood borne viruses and sexually transmissible infections

Five new national strategies for blood borne viruses (BBVs) and sexually transmissible infections (STIs) have been endorsed by the Australian Health Ministers’ Conference. For the next three years, these documents will guide policies in relation to the prevention, testing, treatment and more in relation to BBVs and STIs.
The five new strategies below can be downloaded here.
• The Sixth National HIV Strategy;
• The First National Hepatitis B Strategy;
• The Second National Sexually Transmissible Infections Strategy;
• The Third National Hepatitis C Virus (HCV) Strategy; and
• The Third National Aboriginal and Torres Strait Islander Blood Borne Viruses and Sexually Transmissible Infections Strategy.

National Psychostimulants Initiative (NPI)

The National Psychostimulants Initiative (NPI) aims to reduce harms and prevent harms associated with psychostimulant use in the Australian community. NPI undertakes research, develops the drug and alcohol workforce, disseminates evidence based information to help reduce the impact of psychostimulant drugs in Australia, and educates young Australians about the risks and harms associated with psychostimulant drug use including ice. Have a look at the free publications to download on the NPI website.

Health system expenditure on disease and injury in Australia, 2004-05

The Australian Institute of Health and Welfare has released a new internet only report. Health system expenditure on disease and injury in Australia, 2004-05 provides a systematic analysis of health system expenditures associated with specific disease and injury groups in Australia in 2004-05. Expenditure on cardiovascular disease is compared with expenditure on cancer, injuries, nervous system disorders and other diseases. Health expenditure for each age group ranges from $2,223 per year for girls/boys aged 5 to 14 years to $8,030 per year for women/men aged 75 to 84 years. This report also discusses the changes in expenditure by disease between 2000-01 and 2004-05.
AIHW catalogue number (HSE 87). Click on the link to view the report.
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