Dementia: a major problem for Indigenous people

Recent research in the Kimberley region suggests that the prevalence rates of dementia among remote and rural Indigenous people could be 4-5 times higher than those in the Australian community more generally. The research focused on the development of an assessment tool, (the Kimberley Indigenous Cognitive Assessment tool) in order to identify those Indigenous people who may have dementia. Alzheimers Australia published a paper, Dementia: a major problem for Indigenous people.

To get more information on the KICA tool or download individual parts, go to the Western Australian Centre for Healthy Ageing

Stroke Rehabilitation Audit

Australia has a chronic shortage of specialised stroke rehabilitation services despite the fact that it is the second biggest cause of death and a leading cause of disability, a new report from the National Stroke Foundation has revealed.
Too many stroke survivors are being denied access to the specialised care essential to their recovery and ability to live independently - despite the fact that there are 60,000 strokes occurring in Australia every year, National Stroke Foundation CEO Dr Erin Lalor said.
Download the report here.

Australian National Preventive Health Agency Bill 2010

The agency will lead Australia’s fight against preventable diseases through campaigns targeting obesity, along with alcohol, tobacco and other substance abuse. Minister for Health and Ageing Nicola Roxon said the agency will be critical in combating preventable diseases, which affects the lives of millions of Australians.
As part of the Gillard Government’s record $872.1 million commitment over six years towards the National Partnership Agreement on Preventive Health, the Agency will bring together some of the best expertise in Australia to gather, analyse and disseminate the latest evidence on ways to prevent chronic disease.
At present:
* Potentially avoidable diseases account for around 20 per cent of Australia’s total health care expenditure.
* More than 60 per cent of Australians aged over 18 are overweight or obese.
* More than 813,000 Australians aged 15 years and older were hospitalised for alcohol-related injury and disease between 1996 and 2005.
* Smoking kills about 15,000 Australians each year and costs Australia $31.5 billion each year.
Read or download the full Bill here.

Use of health services for arthritis and osteoporosis

The Australian Institute of Health and Welfare has released a new report on the use of health services for arthritis and osteoporosis. There is considerable variation in the type and extent of health services used and actions taken to manage the three conditions. While the management of osteoarthritis and rheumatoid arthritis is primarily focused on reducing pain and slowing down disease progression, the focus in the case of osteoporosis is largely on containing its role as a risk factor for fractures and other associated complications.
Download the report here.

Glaucoma Guidelines

NHMRC has released the Guidelines for the Screening, Prognosis, Diagnosis, Management and Prevention of Glaucoma . Glaucoma is a chronic degenerative health problem and a leading cause of irreversible blindness worldwide. The Guidelines provide Australian health professionals with current best evidence and clear recommendations for the screening, prognosis, diagnosis, management and prevention of glaucoma. The Guidelines can be found on the NHMRC website.

Australian hospital statistics 2009-10: emergency department care and elective surgery waiting times

Australian hospital statistics 2009-10: emergency department care and elective surgery waiting times presents information relating to emergency department care in major public hospitals and public hospital elective surgery waiting times for the period 1 July 2009 to 30 June 2010. In 2009-10: almost 6 million emergency department presentations were provided by major public hospitals, with 70% of patients receiving treatment within an appropriate time for their urgency (triage category); about 610,000 patients were admitted to Australian public hospitals from waiting lists for elective surgery, with 50% of patients admitted within 36 days.
Click on the link to view the media release and report.

Breast Cancer 2010

The Report to the Nation - Breast Cancer 2010 provides a snapshot of the most up-to-date information on incidence, mortality and survival for breast cancer in Australia.
Download the report here and access other resources from the National Breast and Ovarian Cancer Centre.

Weight loss surgery in Australia

The number of hospitalisations for weight loss surgery has increased dramatically over the past decade, rising from about 500 in 1998 to 17,000 in 2007-08, according to a report released by the Australian Institute of Health and Welfare (AIHW) and funded by the National Health and Medical Research Council (NHMRC).
The report, Weight loss surgery in Australia, shows that between 1998-99 and 2007-08 the number of hospital admissions for weight loss surgery increased by an average of 54% per year, while the total number of all hospital admissions increased on average by less than 4% per year over the same period.

Quality of life and hip fracture.

Even relatively healthy elderly people do not regain their former quality of life within two years after a low-energy hip fracture, according to a study from Norway. The likelihood of a full recovery reduces with increasing age—all of which emphasizes the importance of prevention.
The full article is available for free.

Patient safety during surgery

Paul Barach trained as an anaesthetist and intensive care specialist at Harvard Medical School and has a strong international track record in his research on making health care safer. He now works in Australia and talked with Norman Swan on the ABC Health Report about his presentation at the Women's and Children's Hospital Conference. Paul said, "Health care is not designed for teams. We select, we reward, we incentivise people to work as individuals and then we throw them together in teams. And so unless and until we change the incentive structure and give them the feedback as a team, it's very difficult for them to achieve what I believe can be more sustainable improved results."
Paul believes if you can get the staff to think of themselves as a team and allocate time for debriefing after difficult procedures, "then they're actually able to reflect on their work, learn on the work and grow a greater respect for their colleagues."
To read the transcript of this very interesting interview click here.

The coding workforce shortfall

Concern about the shortfall in the clinical coding workforce in Australia has been raised in a number of national forums. This report quantifies the scope of the existing shortfall, provides some projections of future numbers required to cover increasing demands, and provides a consolidated set of recommendations to address the issues identified. The Australian Institute of Health and Welfare has published this new report today and it can be downloaded in full here.

Influenza and Other Respiratory Viruses

Read these articles and others, as chosen by Editor-in-Chief Alan Hampson, from 'Influenza and Other Respiratory Viruses' free until the end of 2010.
*Pandemic influenza vaccines: meeting the supply, distribution and deployment challenges;
*Confronting the next influenza pandemic with anti-inflammatory and immunomodulatory agents: why they are needed and how they might work.
See the full list of free articles here.

Injury of Aboriginal and Torres Strait Islander People Due to Transport

A report "Injury of Aboriginal and Torres Strait Islander people due to transport, 2003-04 to 2007-08" was released by the Australian Institute of Health and Welfare on 11th November 2010. Land transport accidents accounted for 20% of fatal injury cases and 8% of all injury hospitalisations for Aboriginal and Torres Strait Islander people. Based on age-standardised rates, there were 2.7 times more fatalities and 20% more serious injury among Aboriginal and Torres Strait Islander people compared to other Australians. (AIHW catalogue number (INJCAT 134))

Community Based Aged Care in a Remote Australian Indigenous Setting

An article "Culture at the centre of community based aged care in a remote Australian Indigenous setting: a case study of the development of Yuendumu Old People's Programme" was published in Rural and Remote Health on 26th October 2010. The Warlpiri Aboriginal community in Central Australia wanted to bring their old people home from distant nursing homes. The subsequent development of the Yuendumu Old Peoples Programme and its Family Model of Care shows how this was achieved - and so much more. When government and community worked together respectfully, the power of the traditional system of care based on Law, kinship and 'country' transformed the everyday setting of community based Indigenous aged care - and the final years of many older people. (NRHA e-forum 15 November)

Rural Physiotherapists and Specialist Paediatric Caseloads

An article "Self-efficacy beliefs and confidence of rural physiotherapists to undertake specialist paediatric caseloads: a paediatric example" was published 1st November 2010 in the journal Rural and Remote Health. When patient needs require rural generalists to venture into specialist areas, professional and ethical issues are raised. This study conducted in Queensland, Australia, reports on a survey of rural physiotherapists who have also provided patient care in the specialist field of paediatrics. The findings raise important questions about the nature of rural and remote practice and its impact on the confidence of generalist health professionals, and also rural patients requiring specialist care. (NRHA e-forum 15 November)

Re-issuing of the Joint Statement on vitamin K

The NHMRC has re-issued the Joint statement and recommendations on vitamin K administration to newborn infants to prevent vitamin K deficiency bleeding in infancy. Vitamin K is administered to newborns to prevent vitamin K deficiency bleeding (VKDB). The NHMRC also has available for free download a patient information sheet called "Vitamin K for newborn babies - Information for Parents" which provides straight forward information and advice on the importance of all newborn babies to receiving vitamin K. The document outlines the options for the route of administration of vitamin K and also advises whom parents should contact if they require additional information and guidance.
Download both publications here.

Why junior doctors don't want to become general practitioners

A number of studies suggest there is an over-supply of specialists and an under-supply of GPs in many developed countries. This paper looks at what incentives might help policymakers to address the unbalanced supply of doctors across specialties. It presents results from a discrete-choice experiment completed by a sample of 532 junior doctors in 2008 before they choose a specialty training program.
This paper is written by Peter Sivey, Anthony Scott, Julia Witt, Catherine Joyce and John Humphreys.

Who works beyond the 'standard' retirement age and why?

With life expectancy increasing, and changes to public policy aimed at encouraging older workers to stay in the workforce, the conditions under which people decide to retire have changed in recent years. This report describes the characteristics of those who continue to work beyond the age of 65. The findings show that two groups of workers, in terms of their educational qualifications, are more likely to remain working—the most and least educated—while labour force participation of those with vocational qualifications declines.
Download the report here.

Making Australia Happy

The ABC is airing a three part documentary starting on Monday, 15 November called Get Happy. The series follows the happiness levels of eight "unhappy" people who are encouraged to try to improve their happiness by undertaking various research-based activities. The questions of why some people are perpetually happy while others are not, and whether it is love, money, good looks or good genes that make the difference are addressed. Or is happiness really all in the mind?

In conjunction with the TV program is the ABC's Making Australia Happy website, where you can take the happiness test and participate in various activities to make yourself happier.

Communications Handbook for Clinical Trials

Communications Handbook for Clinical Trials : strategies, tips, and tools to manage controversy, convey your message, and disseminate results, published by Family Health International and authored by Elizabeth T. Robinson et al., is available freely online. Download individual chapters or the whole book. The blurb reads:

"This handbook provides practical guidance to clinical trial staff and research partners on how to anticipate and respond to the special communications challenges posed by the conduct of clinical research. Using context-specific case studies and practical insights culled from actual communications experience in clinical trials from around the world, this essential new resource covers the spectrum of communications planning, activities, and strategies involved in the implementation of a clinical trial. Organized to correspond to the chronological steps involved in conducting research, this guide focuses on the various communications skills that are needed throughout the course of a trial. It contains diagnostic tools, sample templates, and materials that research sites can adapt for use in their communications planning and implementation."

Births, Australia, 2009

A new publication issued by the Australian Bureau of Statistics this week is "Births, Australia 2009." This publication contains statistics for births and fertility in Australia, states and territories, and sub-state regions, based on calendar year of registration data. It also has information on characteristics of the child including place of usual residence, sex, Indigenous status, and age, martial status and country of birth of parents.

Psychosocial Support in Disasters

Minister for Mental Health and Ageing Mark Butler launched a new web portal designed to assist health professionals to provide psychosocial support in disasters. 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. 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. Go to the Psychosocial Support in Disasters site here.

Finding the words - starting a conversation when your cancer has progressed

A new brochure "Finding the words - starting a conversation when your cancer has progressed" has been produced by the National Breast and Ovarian Cancer Centre (NBOCC), a national coordination centre funded by the Australian government to improve breast cancer outcomes through the translation of research evidence into policy and practice. The booklet is designed to help women with secondary cancer talk about how palliative care might help them to live as well as possible when their cancer has spread.This booklet highlights that palliative care is not just about end of life treatment but about helping relieve symptoms and improve day to day life for cancer sufferers. NBOCC resources are available free of charge within Australia.

Clean hearts - keeping little hearts infection free

Kids who need cardiothoracic surgery can be at risk of infection at the surgical site. At The Children's Hospital at Westmead, anaesthetists, cardiac surgeons, nursing staff, the Microbiology department and Pharmacy have worked together to improve their already high standard of patient care. Their work has been recognised, winning a major award in clinical excellence and improvement in patient safety at the 2010 NSW Health Baxter Awards. See the winning presentation here.

Specialized Information Services

The new version of the site Specialized Information Services, part of the National Library of Medicine, has streamlined their information content and has made SIS resources easier to access. The new home page links to NLM online resources and programs in toxicology, environmental health, hazardous chemicals, HIV/AIDS and disaster information management including a "Search Our Resources" feature that searches all SIS Web pages simultaneously. To go directly to the TOXNET site, click on the following : http://toxnet.nlm.nih.gov/

Kidney disease tipped to triple

A REPORT from Kidney Health Australia (KHA) predicts that treating serious kidney disease will cost the health system $12 billion over the next decade. KHA is forecasting the number of people needing treatment for serious kidney disease will triple to 30 000 by 2020. It says the key to bringing down the huge cost is for more people to undergo dialysis at home, saving the health system about $30 000 a year per patient. Dr Tim Mathew, medical director of KHA, says home dialysis is likely to prolong patients’ lives.

Download the full report, "The Economic Impact of End-Stage Kidney Disease in Australia - Projections to 2020 " here.

Pharmaceutical companies and Physician prescribing

In their article, "Information from Pharmaceutical Companies and the Quality, Quantity, and Cost of Physicians' Prescribing: A Systematic Review", PLoS Med. 7(10), 2010, Geoffrey Spurling and colleagues report findings of a systematic review looking at the relationship between exposure to promotional material from pharmaceutical companies and the quality, quantity, and cost of prescribing. They fail to find evidence of improvements in prescribing after exposure, and find some evidence of an association with higher prescribing frequency, higher costs, or lower prescribing quality.

The ABC also covered this story in this week's Health Report. Compere Norman Swan interviewed Geoffrey Spurling about his findings, and you can find the transcript or podcast here. Spurling concludes, "we recommended that doctors follow a precautionary principle and avoid information from pharmaceutical sales representatives unless evidence of benefit emerges. In fact ... the findings support the case for reforms to reduce the negative influence to prescribing from pharmaceutical promotion."

Health and welfare of Aborigines 2010

The Australian Bureau of Statistics has released a comprehensive statistical overview, The health and welfare of Australia's Aboriginal and Torres Strait Islander peoples, Oct 2010 . Here you can find the latest analysis and results from key national statistical collections, the aim from the ABS being to present comprehensive analysis on a more frequent basis. "Information presented will be regularly updated as new source data becomes available, and the range of topics covered will be expanded as new analysis is incorporated."
Key findings so far:

• The Aboriginal and Torres Strait Islander population comprises around 2.5% of the Australian population and is relatively young.
• Aboriginal and Torres Strait Islander Australians have lower life expectancy than non-Indigenous Australians.
• Aboriginal and Torres Strait Islander language and culture is being maintained.
• Socioeconomic outcomes for Aboriginal and Torres Strait Islander Australians continue to improve, but remain below those for non-Indigenous Australians.