International Congress on Telehealth and Telecare

The International Congress on Telehealth and Telecare was held in March this year, organised by The King's Fund in partnership with the University Medical Center Utrecht (UMC).  It brought together speakers from around the world to showcase innovations and best practice in the deployment of telehealth and telecare.  This website includes vodcasts from the speakers on both days, as well as pdfs of presentations.  An excellent source of current information on this topic.

Junior doctors and medical students' commitment to rural placements

Junior doctors’ and medical students’ commitment to working in areas of workforce shortage has just been published in Rural and Remote Health journal.   Australian Government initiatives promote rural training placements, supported medical school places, and incentives that attract doctors to areas of need. The purpose of this study was to report on the preparedness of medical students and junior doctors to commit to working in areas of workforce shortage.  The study was based on a web-based survey, and responses were received from 760 medical students and 264 junior doctors. A substantial proportion of this sample were prepared to make some form of commitment to providing medical services in a rural area. The greatest proportion (38.3%) was prepared to make a small commitment equal to an irregular locum service of 1 week or 1 month per year.
The authors conclude that government policies and incentives may be having a positive effect on medical students’ and junior doctors’ preparedness to work in rural and remote areas and that medical educators should encourage students and junior doctors to take up short-term placements/opportunities and to maintain links with rural communities. 

Rural Workforce special issue of AJRH

The Australian Journal of Rural Health has published a special open-access issue, entitled Rural Workforce Research, March 2011.  Edited by David Perkins, the fact that rural residents have the poorest access to health services in Australia is highlighted as a function of workforce shortages and problems in the distribution of health care professionals. Workforce issues are a major concern for rural health researchers and policy makers and the subject of many innovative studies. "This virtual edition of the AJRH brings together a selection of these papers illustrating the scope and variety of workforce problems and relevant published research. It should be of interest to rural health professionals, researchers, students and policymakers."

Dental and oral health - two reports

Dental attendance patterns and oral health status has been published by the AIHW this week, and found a significant oral health gap between Australians who regularly visit a dentist and those who don’t.  Surveys were conducted to ascertain self-reported patterns of dental attendance, and participants were categorised into "Favourable", "Intermediate" and "Unfavourable" attenders.  The group with an unfavourable pattern of dental attendance (about 30% of Australian adults), had significantly poorer oral health outcomes than those with favourable attendance.  They were were 3.7 times more likely to have had a tooth extracted in the previous year and were also more likely to report barriers to accessing dental care than those with favourable attendance. In particular, they were 3 times more likely to report delaying or avoiding dental care due to cost and being very afraid or distressed when making a dental visit.

The Australian Indigenous HealthInfoNet has also published an oral health report, Review of Indigenous oral health.  The authors found that indigenous Australians have poorer oral health than other Australians, suffering from more caries, periodontal diseases, and tooth loss than non-Indigenous people. Tooth decay among the Indigenous population more commonly goes untreated, leading to more extractions.

This discrepancy is attributed in part to the fact that access to culturally appropriate and timely dental care is often not available to Indigenous people, especially in rural and remote areas. Other information on oral health such as culturally appropriate resources about maintaining healthy teeth and mouths, and nutritional guidance on how much sugar is contained in certain foods and drinks, is also less available for the Indigenous Australian population.

Use of population health research in NSW Health

Developing a strategy to promote the generation and effective use of population health research for NSW Health: 2011–2015, by Beth Stickney and Janice S. Biggs has just been published in The NSW Public Health Bulletin.

The NSW Department of Health has developed a 5-year strategy to improve the effectiveness of its resource investment in population health research.  The authors reviewed Australian and international strategic research documents and also conducted stakeholder interviews.  From this they were able to identify research priorities, aiming to enhance networks and partnerships, support workforce development initiatives and provide research infrastructure.  The Population Health Division will facilitate implementation of the Strategy and report on progress and outcomes.

Australian hospital statistics - AIHW reports

Australian hospital statistics 2009-10 presents a detailed overview of Australia's 1,326 public and private hospitals.  In 2009-10, there were 8.5 million separations from Australia's hospitals including 4.8 million same-day acute separations, 3.5 million overnight acute separations and almost 337,000 non-acute separations. There were 7.4 million presentations to public hospital emergency departments, with 70% of patients seen within the recommended times for their triage categories.

Australia's hospitals 2009-10 at a glance has been published in conjunction with the detailed statistics and provides summary information on Australia's 1,320 public and private hospitals.  

Chronic Fatigue Syndrome - controversy over treatment

ABC Radio National's Health Report this week looked at the controversy surrounding a paper published in the Lancet last month.  The paper, by White PD et al. 'Comparison of adaptive pacing therapy, cognitive behaviour therapy, graded exercise therapy, and specialist medical care for chronic fatigue syndrome (PACE): a randomised trial,' assessed the effectiveness and safety of four treatments for people suffering from chronic fatigue syndrome.

The trial seemed to report some good news for CFS sufferers, but there has been much criticism from patient groups and retractions have been sought.  Norman Swan talks to one of the researchers, Michael Sharpe, as well as the Editor-in-Chief of the Lancet, Richard Horton. 

Read the transcript of the interviews, or download the podcast here.  The many comments made by listeners at the end of the transcript are interesting as well, and show divided views about what Chronic Fatigue Syndrome really is.

The fulltext of the Lancet article can be obtained via CIAP, or contact your Library.
The Lancet March 5, 2011;377:823–36

Dental attendance and oral health report

Dental attendance patterns and oral health status has been published by the AIHW this week.  The findings are sourced from the 2004–2006 National Survey of Adult Oral Health (NSAOH), where a random sample of Australian adults was interviewed by telephone to collect information on dental attendance patterns and self-reported oral health. An oral examination was then undertaken to collect information on tooth decay and gum disease.

The results indicated that 40% of Australian adults visit the dentist at least once a year for a check-up while nearly 30% visit infrequently and usually for a dental problem. Those with an unfavourable pattern of dental attendance had more than 3 times the level of untreated decay and 1.6 times more teeth missing due to dental disease than those with a favourable pattern of attendance. They were also more likely to report avoiding or delaying dental care due to the cost and being very afraid or distressed when making a dental visit.

The Easter bunny and the chocolate conspiracy

Nathan J. Grills has published "The Easter Bunny and the chocolate conspiracy," a  tongue-in-cheek look at the public health aspects of Easter, in this week's Medical Journal of Australia.  He writes, "The Easter Bunny (EB) has been popularised and exploited by chocolate manufacturers and other companies selling this energy-dense, nutrient-poor (EDNP) food. Since when did bunnies lay eggs made of chocolate? Is this a conspiracy to sell lucrative chocolate eggs?  I have argued that Santa Claus is a public health pariah who advertises unhealthy products to children and normalises obesity, but what about the EB — is this bunny an innocent fairytale character or another unhealthy childhood role model?"

MJA 2011; 194 (8): 410-412

Update on Chronic Heart Failure guidelines

The 2011 update to guidelines for the prevention, detection and management of chronic heart failure in Australia, 2006, has been published by The Heart Foundation and the Cardiac Society of Australia and New Zealand, and is now available in the latest issue of the Medical Journal of Australia.
The update reflects new evidence relating to the use of B-type natriuretic peptide (BNP), including plasma-BNP or N-terminal, pro-BNP measurement in guiding treatment of chronic heart failure, physical activity and rehabilitation, pharmaco-therapy, the use of polyunsaturated fatty acids in the treatment of systolic heart failure, the use of devices such as biventricular pacing and left ventricular assist devices and the treatment of cardiac arrhythmias in patients with chronic heart failure.
MJA 2011; 194 (8): 405-409. Please contact your library if you have trouble accessing the full text of this article.

Study on self-removal of earwax

Last week's Health Report on Radio National included an interview about removing earwax with Richard Coppin, who has just published a study into the safety of using syringing bulbs to clear wax out of ears. The study showed that "for patients who have not already tried bulb syringes, self-irrigation using a bulb syringe significantly reduces subsequent demand for ear irrigation by health professionals. Advocating the initial use of bulb syringes could reduce demand for ear irrigation in family practice clinics." Coppin R et al. Randomized Trial of Bulb Syringes for Earwax: Impact on Health Service Utilization. Annals of Family Medicine 2011, 9 (2) :110-114. Please contact your library if you have trouble obtaining the fulltext of this article.

Work-related fatalities report

The Notified fatalities statistical report 2009-10 from Safe Work Australia, analyses work-related fatalities that occurred between 1 July 2009 and 30 June 2010. In that period there were 124 notified fatalities - 111 workers and 13 bystanders. Some of the findings were:

• Most fatalities were of men — 115, compared to 9 women.


• 23% of fatalities occurred at a workplace primarily engaged in Agriculture, forestry & fishing; 17% in Construction; 13% in Manufacturing; 11% in Transport & storage; and 5% in Mining.


• The most common causes of the fatalities were Vehicle incidents (26); Falls from a height (20); Being hit by falling objects (18); Being hit by moving objects (18); and Contact with electricity (12).

Social Science Library - new database

Social Science Library: frontier thinking in sustainable development and human well-being contains complete bibliographic references for nearly 10,000 journal articles, book chapters, and working papers in the disciplines of Anthropology, Economics, History, Political Science, Social Psychology, Sociology, and Philosophy. Developed by the Global Development And Environment Institute (GDAE) in conjunction with the United Nations Decade for Education for Sustainable Development, the SSL is primarily intended for researchers, students, and policy-makers in less-wealthy countries who are working to promote sustainable development and human well-being. Having about a third of its abstracts also available in fulltext, it's a useful database for anyone interested in social science research.

Transport accident trends in Australia - AIHW report

Trends in serious injury due to land transport accidents, Australia is a report from the AIHW, presenting trends of serious non-fatal injury due to land transport accidents in Australia over the period 2000-01 to 2007-08 with a focus on road vehicle traffic crashes. Over the 8-year period, age-standardised rates for persons seriously injured due to a road traffic crash increased from 138.4 to 153.4 per 100,000 population. Over one-quarter (28%) of those seriously injured due to a road traffic crash sustained life-threatening injuries. Drivers of motor vehicles, motor cyclists and pedal cyclists all recorded significant increases in age-standardised rates of life-threatening injury over this period. For males aged 45-64 years, the combined total of high threat to life injuries due to motorcycle and pedal cycle road traffic crashes as a percentage of all high threat to life injuries due to road traffic crashes rose from almost 30% in 2000-01 to 50% in 2007-08

Women, Health and Ageing report

The latest major report from the ongoing Australian Longitudinal Study on Women's Health has been released. The report, Women, health and ageing: Findings from the Australian Longitudinal Study on Women's Health, includes information and analysis from the fifth survey over time on the same set of 40,000 women drawn from three age groups. This report focuses on women born between 1921 and 1926, now aged 85-90. Ischaemic heart disease is reported as the leading cause of death and disability for women aged 65 and older. Among women aged 65-74, type 2 diabetes and breast cancer are the next two highest causes, while dementia and stroke are the next two highest causes of death and disability among women over age 75. Other findings included the fact that only 9% of the women were engaging in high levels of physical activity and another 4% were engaging in very high levels. Moderate and high levels of physical activity were associated with lower risk of falls among women aged 70-75 years and very high levels of physical activity were associated with reduced incidence of fractures among women aged 70-75 years.

Allied health workforce - journal article

"Measuring rural allied health workforce turnover and retention: What are the patterns, determinants and costs?" has just been published in The Australian Journal of Rural Health [19 (2) : 81-88, April 2011], The authors' aim was "To measure variations in patterns of turnover and retention, determinants of turnover, and costs of recruitment of allied health professionals in rural areas." They looked at a variety of allied health professions in 18 health districts in Western Victoria over a period of five years and concluded that the geographical location of the worker effected their likely retention between 12 and 24 months of employment, so there should be comprehensive retention strategies in the first year of employment in rural and remote settings. Please contact your library if you have trouble linking to the fulltext of this article.

Health and the Environment report

There is increasing awareness that our health and the environment in which we live are closely linked. Health and the Environment : a compilation of the evidence, from the AIHW, studies the relationship between health and a selected list of natural environmental factors (such as temperature and ultraviolet radiation) and human environmental factors (such as housing and transport). The results show that our surroundings can influence our physical health and mental wellbeing in both positive and negative ways and that human intervention can play a vital role in exacerbating or reducing health risks.

Bowel cancer screening issues

Why bowel cancer screening is a needed health care investment is the most recent paper from the Menzies Centre for Health Policy. The authors, Sarah Wenham and Leslie Russell, point out that "This year 17,000 Australians will be diagnosed with bowel cancer, every week 80 people will die from this disease, and the cost of treatment will hit $1 billion. So it is shocking to realise that Australia’s nascent National Bowel Cancer Screening Program (NBCSP) has run out of funding and ground to a halt." They go on to point out that Australia's bowel cancer incidence is one of the highest in the world - surpassing the UK and the USA. They analyse the history of the NBCSP, look at programs in other countries and mount an argument for not only continued funding of the program, but a new commitment to it.

Social workers need more recognition

It is time for social workers to claim their place in Australia’s health care system is the title of a paper by Alice Clark, a research fellow at the Quality Use of Medicines & Pharmacy Research Centre, University of South Australia. She writes, "The social work and human services professions do not currently have national workforce or curriculum plans. Without them, it is possible that the needs of society and the sector will not be met." Clark also believes social workers are needed in primary health teams and must be trained accordingly.