Use of Mass Media Campaigns to Change Health Behaviour

"The Use of Media Campaigns to Change Health Behaviour" is a recent article in The Lancet. The authors look at the use of mass media campaings to expose populations passively to health information. They discuss the outcomes in the context of various health-risk behavious such as the use of tobacco, alcohol and other drugs, heart disease risk factors, sex-related behaviours, road safety, cancer screening and preventino, and organ or blood donation. They analyse what makes the campaigns work, having concluded that they "can produce positive changes or prevent negative changes in health-related behaviours across large populations", and also suggest areas for future improvement.

This article is available through CIAP or by contacting your hospital library. Lancet
Volume 376, Issue 9748 pages 1261-71, 9 October 2010.

Improving stroke therapy

A study in the latest Medical Journal of Australia by Marion Simpson et al, is called, Thrombolysis for acute stroke in Australia: outcomes from the Safe Implementation of Thrombolysis in Stroke registry (2002-2008). (Medical Journal of Australia 2010;193;7:439-443).

Thrombolysis for acute stroke with recombinant tissue plasminogen activator (rt-PA) is increasingly being used in metropolitan and regional hospitals. Randomised controlled trials have shown that rt-PA given within 3 hours of onset of stroke symptoms improves outcome with reduced disability at 3 months, "albeit with a small risk of serious harm, usually related to intracranial haemorrhage." This study compared Australian outcomes with those overseas and found that they are similar to those worldwide.

This week's Health Report on ABC's Radio National included an interview with one of the authors of the MJA paper, Chris Levi. His concern was that this treatment is "very effective but not available to all Australians as It's still only around 5% of stroke patients that come to our major metropolitan and major rural hospitals that are receiving tPA out of approximately 30% that would be eligible". He says the barriers are the workforce and training capabilities of our system.

The Economics of childhood obesity

The Productivity Commission has published a report, Childhood obesity : an economic perspective. The weight of Australian children has increased markedly in recent decades, to the point where around 8 per cent are defined as obese (based on Body Mass Index), and 17 per cent as overweight. The problem has been linked to a raft of physical and psychosocial health problems, including type 2 diabetes and cardiovascular disease, as well as social stigmatisation and low self-esteem.

This report indicates that there is only limited evidence of interventions designed to address childhood obesity achieving their goals. The authors suggest that the issue childhood obesity is complex and that policies need to be carefully designed to maximise cost-effectiveness, with a focus on evidence gathering, information sharing, evaluation and consequent policy modification.

Digestive Diseases information

The National Digestive Diseases Information Clearinghouse is a service of the U.S. National Institute of Diabetes and Digestive and Kidney Diseases, NIH. It provides a large number of plain language resources on digestive diseases, including a special section on coeliac disease. There are fact and information sheets, links, statistics, reviews of clinical trials and practice guidelines. There are also links here to their other equally useful clearinghouse sites on Diabetes, Endocrine & Metabolic Diseases, Haematologic Diseases and Kidney & Urologic Diseases.

Trauma and Resilience: Mind, Body, and Spirit

Dr. Maria Mouratidis, a Bethesda Naval Medical Center expert on traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD), spoke on "Trauma and Resilience: Mind, Body, and Spirit," at the National Library of Medicine. NLM has made this informative lecture and discussion available. You may watch a streaming version of the video at your computer or download it for viewing later. A full transcript is also available.

Access to and uptake of adult health services and outcomes for young people with type 1 diabetes in regional New South Wales

The Medical Journal of Australia recently published an article discussing young people with diabetes and their transition to adult diabetes care in both regional and city areas. Inadequate routine specialist care, poor diabetes self-management and frequent use of acute services for crisis management, particularly in regional areas, suggest service redesign is needed to encourage young people’s engagement. Read the full article here.

No quick fix: three essays on the future of the Australian public hospital system

Until the mid-1980s, Australian public hospitals were managed by their own boards of directors. When hospital boards were abolished, state governments established centralised health bureaucracies to administer hospitals and other health services within designated regions, such as the eight ‘area health services’ in New South Wales. Describing the negative impact the bureaucratisation of the hospital system has had on staff and patients in the last 30 years, these essays argue for the reestablishment of local hospital boards. The three essays are:
1. Radical Surgery: The Only Cure for Public Hospitals
2. An Insider’s Perspective on Hospital Administration
3. Why Public Hospitals Are Overcrowded: Key Points for Policymakers
Read the documents here.

RACGP Standards for General Practice - New Edition

The RACGP Standards for General Practice 4th edition were officially launched at GP10, the RACGP annual conference, in October 2010. The 4th edition of the Standards represents a template for quality and risk management in contemporary general practice. The review process included a separate e-health standards working group to review all the standards and their alignment with national e-health initiatives (patient, provider and organisation healthcare identifiers, and electronic health records) and best practice.

Guide for Using Statistics for Evidence Based Policy

There is an increasing emphasis within Australia, and internationally, on the importance of using good statistical information when making policy decisions. The 'Guide for Using Statistics for Evidence Based Policy' provides an overview of how data can be used to make well informed policy decisions and includes the following information:

• What is evidence based decision making?


• How good statistics can enhance the decision making process


• Using statistics for making evidence based decisions


• Data awareness


• Understanding statistical concepts


• Analysing and evaluating statistical information


• Communicating statistical findings


• Evaluating policy outcomes

(From: Australian Bureau of Statistics 20 October 2010)

Workers with Mental Illness: a Practical Guide for Managers

The Australian Human Rights Commission has produced a guide Workers with mental illness: a practical guide for managers. The guide aims to help managers better understand mental illness, develop strategies that assist workers with a mental illness and ensure that their workplaces are healthy and productive," President Branson said. "We developed this guide because research conducted by the Australian Human Rights Commission showed that managers want to provide support to staff members who live with a mental illness, but often lack the confidence or skills to do so," said President Branson.
The guide has been released after extensive consultation with the business community, trades unions, disability organisations, workplace safety bodies and employers. "During any year, approximately one in five Australian adults will experience a mental illness. It is our hope that this guide will assist managers to understanding their legal obligations while developing strategies that support their staff and reduce the incidence of illness in the workplace," said President Branson.
The guide has been endorsed by the Fair Work Ombudsman, beyondblue: the national depression initiative, SANE Australia, the Mental Health Council of Australia, and supported by Safe Work Australia.

Heart failure and palliative care

Heart failure is the only cardiac disease which is increasing in prevalence. Despite continuing improvements in treatment which can prolong and improve the lives of heart failure patients, it remains a terminal condition with a heavy burden of symptoms, especially in the advanced stages.
CareSearch is an online resource of palliative care information and evidence. It has recently introduced a new set of Clinical Practice pages providing a summary of the systematic review level evidence for heart failure in a palliative care context.
Access the information here.

Australian Guidelines for the Prevention and Control of Infection in Healthcare (2010)

There are around 200,000 healthcare-associated infections (HAIs) in Australian acute healthcare facilities each year. This makes HAIs the most common complication affecting patients in hospital. As well as causing unnecessary pain and suffering for patients and their families, these adverse events prolong hospital stays and are costly to the health system.

NHMRC’s Australian Guidelines for the Prevention and Control of Infection in Healthcare (2010) are now available on the NHMRC website.
The Guidelines support the Australian Commission on Safety and Quality in Healthcare’s work in preventing healthcare associated infections.

Internet Addiction

Internet addiction appears to be a relatively common behavioural addiction, the prevalence of which has been estimated to range from 1% to approximately 14%. A study supported by the Beijing Municipal Natural Science Foundation has formulated a list of proposed diagnostic criteria for internet addiction. The article, published in the journal Addiction is available here.

Database of Genomic Structural Variations

The National Institutes of Health (NIH) announced the launch of a new resource, called the Database of Genomic Structural Variation, or dbVar, to help scientists understand how differences in DNA contribute to human health and disease.
The database will help track large-scale variations in DNA discovered in healthy individuals as well as those affected with disorders such as autism and cancer.
The database can be accessed here.

Critical Care in the Intensive Care Unit

This weeks Lancet has a number of excellent review articles relating to critical care. You can access these articles through the Online Journal list on CIAP or check with your Librarian.

Critical care and the global burden of critical illness in adults
Ethics and end-of-life care for adults in the intensive care unit
Critical care: advances and future perspectives

Rural Mental Health Workforce Difficulties

The recruitment, retention and training of mental health workers is of major concern in rural Australia. A study has recently been conducted to look at this issue from the perspective of managers of rural mental health services. "Rural mental health workforce difficulties: a management perspective" is published in the Rural and Remote Health Journal. The information provided by this research complements studies of the clinicians themselves, and so offers a unique contribution to achieving a sustainable and effective rural mental health workforce.

Psychosocial Support in Disasters Web Portal

The Minister for Mental Health and Ageing Mark Butler has launched a new web portal designed to assist health professionals to provide psychosocial support in disasters. The web portal will assist in the areas of preparation, support, and recovery for individuals and communities affected by disaster, like the Black Saturday bushfires.



The Psychosocial Support in Disasters web portal will act as a central access point to vital information, helping those in disaster-prone areas to prepare psychologically, providing practical support during the emergency, and providing social, emotional and psychological support during the recovery period. There is also a section with information for the general public.

The web portal is a joint initiative of the Australian Psychological Society, the Australian Centre for Posttraumatic Mental Health, Occupational Therapy Australia, the Royal Australian and New Zealand College of Psychiatrists, the Australian Association of Social Workers, the Royal Australian College of General Practitioners and General Practice Victoria.

A Snapshot of Arthritis in Australia 2010

The Australian Institute of Health and Welfare has released a new report : A snapshot of arthritis in Australia 2010. This report brings together the latest data on arthritis in Australia. The purpose of the snapshot is to provide the latest statistical information in a timely and efficient manner. (AIHW catalogue number (PHE 126))

Medical and Nursing Workforce Reports 2008

The Australian Institute of Health and Welfare (AIHW) has released two new reports:

Nursing and midwifery labour force 2008 - In 2008 the total number of registered and enrolled nurses estimated by the Nursing and Midwifery Labour Force Survey was 312,736, an increase of 10.6% since 2004. The nursing workforce continued to age between 1997 and 2008; the proportion of nurses aged 50 years or over increased from 18.9% to 34.4%. The number of full time equivalent nurses per 100,000 population increased by 15.2 % between 2004 and 2008, and the profession continued to be predominantly female, with females comprising 91% of employed nurses in 2008. (AIHW catalogue number (AUS 130)

Medical labour force 2008 - The supply of employed medical practitioners increased between 2004 and 2008, from 283 to 304 full-time equivalent practitioners per 100,000 population. The increase reflected a 20.5% rise in practitioner numbers. The gender balance continued to shift, with women making up 35% of practitioners in 2008 compared to 33% in 2004. The average hours worked by male practitioners declined from 47.1 to 45.4 hours, while hours worked by female practitioners changed marginally from 37.6 to 37.7 hours. (AIHW catalogue number (AUS 131)

Stroke education for health professionals

The e-Stroke Australia site, developed by the Victorian Stroke Clinical Network, the Stroke Society of Australasia and the Victorian Government, provides continuing education on stroke for health professionals. It "has been developed primarily for junior doctors but should be accessible to any clinician working with stroke patients."

A wide range of e-learning modules are available including stroke prevention, pathophysiology, transient ischaemic attack, CT interpretation, medication and surgery. Registration for these is free and there are also lots of useful links to other stroke-related sites.

NSW Suicide Prevention Strategy

The NSW Department of Health has released The NSW Suicide Prevention Strategy 2010-2015, setting out its direction and intended outcomes for suicide prevention over the next five years.

The six priority areas identified in the strategy were:
1. Improving the evidence base and understanding of suicide prevention
2. Building individual resilience and the capacity for self help
3. Improving community strength, resilience and capacity in suicide prevention
4. Taking a coordinated approach to suicide prevention
5. Providing targeted suicide prevention activities
6. Implementing standards and quality in suicide prevention

College of Nursing postgraduate courses 2011

A PDF of the College’s 2011 “Postgraduate Studies 2011 - graduate certificate courses and distance education subjects” is now on the web at: http://www.nursing.edu.au/pdf/2011_Handbook_Web_140910.pdf

With national registration of nurses having started from July 2010, nurses Australia-wide are now required to undertake a minimum of 20 hours continuing professional development each year to meet the annual registration standards. Most College courses will assist in meeting this requirement.

More information about national registration can be found at the Nursing and Midwifery Board of Australia’s Website.

Measuring the Metropolitan-Rural Inequity

The National Rural Health Alliance (NRHA) has released a new five-page report from the NRHA detailing some of the metropolitan-rural inequities that justify special regional investments by the new Gillard Government. The report covers differences in life expectancy, access to health professionals, health status and risk factors, cancer survival rates, education and educational outcomes, and communications, among others.

Prevention and cost effectiveness

Assessing Cost Effectiveness in Prevention is the report of a major study published this week by the Public Health Association of Australia. There is a need to ensure our scarce health resources are directed to where they can be most effective - particularly for those with the poorest health outcomes. This five-year study, funded by the NHMRC, and run under the auspices of the Centre for Burden of Disease and Cost-Effectiveness at the University of Queensland and Deakin Health Economics at Deakin University, is a comprehensive analysis of the value of many health advancement strategies to address the burden of preventable death and disease in Australia.

The report evaluated the cost-effectiveness of 150 preventive health interventions in areas such as mental health, diabetes, tobacco use, alcohol use, nutrition, body weight, physical activity, blood pressure, blood cholesterol and bone mineral density. The interventions which have the largest impact were considered to be the taxation of tobacco, alcohol and unhealthy foods, a mandatory limit in salt in bread, cereals and margarine, choosing the most cost-effective, generic drugs for blood pressure and cholesterol lowering, gastric banding for severe obesity and an intensive SunSmart campaign.

Expenditure on Health for Aboriginal and Torres Strait Islander People 2006-07

Health expenditure patterns, and the ratios between Indigenous and non-indigenous expenditure, vary by remoteness and by the type of health expenditure. This is the subject of a report by the Australian Institute of Health and Welfare (AIHW) "Expenditure on health for Aboriginal and Torres Strait Islander people 2006-07 : an analysis by remoteness and disease". For example, Medicare Benefits Schedule expenditure was lower for Indigenous Australians and decreased with remoteness, but the level of disparity actually decreased with remoteness, from a ratio of 0.58 in major cities to 0.77 in remote areas. (AIHW catalogue number (HWE49))