Keeping the Child in Mind

The Department of Families and Communities in South Australia has published a new report
Keeping the child in mind: child protection practice and parental mental health available for download. The publications reports on a study which examines the prevalence of parental mental health disorders in child protection matters, including the types of mental health disorders associated with protective concerns for children

Global Tobacco Epidemic

On July 7, the WHO report on the Global Tobacco Epidemic 2011 was launched. This report focuses on warning people about the dangers of tobacco use through health warning labels on packaging and national anti-tobacco mass media campaigns.

To download the report and related materials, click here.

Cardiovascular Disease in Women

Although cardiovascular disease is the number one killer of both men and women in the USA, more women die yearly—close to 500 000. Women are twice as likely as men to have heart failure, 1·5 times more likely to die within a year of a heart attack, and twice as likely to have a poor outcome after a coronary artery bypass graft. Furthermore, the cardiovascular mortality rate is rising in women younger than 55 years. Women often have non-chest-pain-specific cardiovascular symptoms. Two-thirds of women who die suddenly of coronary heart disease have no symptoms, probably reflecting a distinct microvasculature cause of cardiovascular disease in women.
Two US organisations, WomenHeart: The National Coalition for Women with Heart Disease and the Society for Women's Health Research, have released Report: Advancing Women's Heart Health Through Improved Research, Diagnosis and Treatment. The report emphasises the burden of cardiovascular disease in women and the disappointing lack of research into this predicament.

Ovarian cancer topics

Last week's Health Report on ABC's Radio National concentrated on three aspects of ovarian cancer.  Click on the titles to download, podcast or read the transcript of the program.

• Screening - a study in the US, involving over 70,000 women, has investigated the effect of screening on ovarian cancer mortality.  The researchers concluded that the benefits of screening did not outweigh the risks.  The study has been reported in this article : Buys SS et al. Effect of Screening on Ovarian Cancer Mortality. JAMA 2011;305(22):2295-2303
• Education campaigns - An Australian longitudinal study attempted to discover what symptoms associated with ovarian cancer need to be investigated further and when not to be concerned. Three major symptoms were identified, which in conjunction with persistence and severity indicated a need for intervention.  Pitts MK et al. High prevalence of symptoms associated with ovarian canc er among Australian women. Australian and New Zealand Journal of Obstetrics and Gynaecology 2011;51:71-78
• Genome - An international research project, with the participation of two Australian scientists, has mapped genetic mutations in the most common form of ovarian cancer, giving hope for the development of new, targeted treatments.  Read more in The Cancer Genome Atlas Research Network. Integrated genomic analyses of ovarian carcinoma. Nature 2011;474:609-18 

If you have trouble accessing any of the articles referenced above, please contact your hospital library.

TGA Transparency Review released

The Australian Government has released the report of the Therapeutic Goods Administration (TGA) Transparency Review panel, chaired by Professor Dennis Pearce. The purpose of the review was to improve public knowledge of regulatory decision-making and to enhance public understanding of the benefits and risks of therapeutic goods so that the Australian community can understand how the TGA operates and the reasons for its key decisions.
A copy of the Review Report is available at http://www.tga.gov.au/newsroom/review-tga-transparency-1101.htm.

Guidelines for ethical indigenous research

An updated Guidelines for Ethical Research in Australian Indigenous Studies has been released by the Australian Institute of Aboriginal and Torres Strait Islander Studies. The guidelines reflect developments in critical areas that have emerged since the previous edition in 2000, such as changes to intellectual property laws, rights in traditional knowledge and traditional cultural expressions, and the establishment of agreements and protocols between Indigenous people and researchers. They also take into account emerging developments in digitisation, and data and information management, and the very significant impacts this has on research and other aspects of Indigenous studies.

World report on disability - WHO

The World Report on Disability from WHO/World Bank, reviews evidence about the situation of people with disabilities around the world.  About 15% of the world's population lives with some form of disability, of whom 2-4% experience significant difficulties in functioning.  This is higher than previous WHO estimates of around 10%  due to a combination of factors such as population ageing and the rapid spread of chronic diseases, as well as improvements in the methodologies used to measure disability.

The report begins with chapters on understanding and measuring disability and then goes on to the specific areas of rehabilitation, assistance, enabling environments, education and employment. Within each chapter, there is a discussion of the barriers confronted, and case studies showing how countries have succeeded in addressing these by promoting good practice. The report concludes with nine recommendations for policy and practice which if put in place could lead to real improvements in the lives of people with disability.

Before it's too late: Report on early intervention programs aimed at preventing youth suicide

"Every year in Australia suicide claims the lives of around 2000 Australians placing it ahead of road traffic accidents and skin cancer as a cause of death. For young people aged 15 to 24, it is the number one cause of death. Despite this, in recent years the issues of mental health and suicide prevention have received comparatively less mainstream policy attention and seemingly less program funding than well resourced and public road safety and sun protection campaigns."
The report "Before it's too late: Report on early intervention programs aimed at preventing youth suicide" stemmed from the government Inquiry into Early Intervention Programs Aimed at Preventing Youth Suicide.
Download the report here.

RHEF: Recent Programs on Pain, Injury and Smoking

Recent programs broadcast by the Rural Health Education Foundation are recorded and are available online to view or listen at your convenience. Click on the "view high res" or "view low res", "listen" or "download podcast" buttons on the program webpage. Recent programs are:
When Pain Persists: Pain Management in Primary Health
Living Safely: Preventing Accidents & Injury in Indigenous Communities
Smoking: An Indigenous Health Challenge

Australian Journal of Advanced Nursing - new issue

AJAN is available freely online, and Volume 28, Number 4, June-August 2011 is now available.  Articles include (among many others)

• Team nursing: experiences of nurse managers in acute care settings
• “I don’t want to become a scientist”: undergraduate nursing students’ perceived value of course content
• Occupational stress in the Australian nursing workforce: a comparison between hospital-based nurses and nurses working in very remote communities
• Postoperative hypothermia and mortality in critically ill adults: review and meta-analysis
• Medication calculation competencies for registered nurses: a literature review

Health care services - statistics 2009-2010

The Australian Bureau of Statistics has released a report, 8570.0 Health Care Services 2009-10.  It   presents estimates of the financial performance and workforce characteristics of private sector businesses and organisations involved in the provision of health care services during the 2009-10 financial year and contains information such as income and expenditure, employment, workforce characteristics, state and regional breakdowns of key data items, performance ratios, and patient/client data.

CareTrack Australia - health care research

CareTrack Australia is part of an NHMRC program grant to the Australian Institute of Health Innovation that will examine the appropriateness of the care provided in Australia for 22 common conditions. "Previous studies have demonstrated that patients receive evidence-based care for common conditions approximately half of the time, and that there is considerable variation in the care that is provided." The study aims to understand who is getting what healthcare from whom, and how and why, from the perspectives of both patients and healthcare providers. They will review the medical records from 2009 and 2010 from 1000 representative Australians.

One of the chief investigators, Professor Bill Runciman, was interviewed last week on ABC Radio National's Health Report.  He said that a similar review in the US revealed American adults received the evidence-based consensus recommended care about 55% of the time and children about 46% of the time.  Download the interview or the transcript here.

Aboriginal and Torres Strait Islander experiences of chronic illness

"People I can call on" is a community report from the Serious and Continuing Illness Policy and Practice Study, (SCIPPS) Menzies Centre for Health Policy.  Nineteen people talked to SCIPPS researchers about what life was like living with chronic illness.

Strengthening the capacity of people to provide effective informal support benefits everyone. People in this study described challenges they experience in their daily lives, in relationships with family members, and in consultations with healthcare workers. They indicated that they want to increase their health knowledge so they can assist other members in their community, but they only wanted unsolicited help if it made them feel empowered and positive.  The report provides suggestions for the ways in which healthcare workers, health services and policy can help.

Advertising of fast-food to Australian children

"Advertising of fast food to children on Australian television: the impact of industry self-regulation" is the title of a study just published in the Medical Journal of Australia by Lana A. Hebden et al. [MJA 195(1) : 20-24, 4 July 2011].
 One of the key recommendations of the National Preventative Health Taskforce was that children’s exposure to advertising of unhealthy foods should be reduced.  In response, the federal government recommended that the Taskforce continue to monitor the impact of self-regulation by food and advertising industries before the government took any further action. 


The most recent self-regulatory initiative, the Australian Quick Service Restaurant Industry (QSRI) Initiative for Responsible Advertising and Marketing to Children, specified that fast-food companies  should “ensure that only food and beverages that represent healthier choices are promoted directly to children . . .”  In 2009 several major companies signed off on this agreement to ensure they would only advertise to children under 14 years of age products that represent healthier choices and/or represent a healthy lifestyle.

The authors aimed to measure the impact of the QSRI initiative on the rates of fast-food advertising on Australian commercial television by comparing advertising in the same week and time-slots in 2009 and 2010.  They found that from 2009 to 2010, the mean frequency of fast-food advertisements increased from 1.1 to 1.5 per hour. "Family meals advertised for children’s consumption in 2010 provided energy far in excess of children’s requirements."  They concluded that self-regulation was not effective.

After hours GP helpline

The after hours GP helpline has been introduced by the Australian Government from 1 July 2011 as part of the National Health Reform. If you want to know more about it, go to the YourHealth website. The site will also take you to printable brochures, posters and factsheets, as well as FAQs and all the reasoning behind the initiative.

Effects of e-Health on chronically ill patients

"A systematic review of the effects of e-health on chronically ill patients" by P. Eland-de Kok P,  et al. has been published in the Journal of Clinical Nursing, [doi: 10.1111/j.1365-2702.2011.03743.x].

The study investigates the effects of e-health interventions versus face-to-face care on the health outcomes of chronically ill patients. Twelve randomised controlled trials were included and they were divided into e-health versus usual care or e-health in addition to usual care. The authors suggest e-health for both types of studies led to small to moderate positive effects on health outcomes, "however, the evidence was not fully convincing, because of the limited number of studies available and the methodological limitations. Further research is needed to confirm the cost-effectiveness of e-health interventions for patients with chronic diseases."

The article is available in full text via CIAP, or contact your health library.

A pilot study of psychosocial factors and cardiovascular risk amongst Aboriginal people living in the Goulburn Valley

Cardiovascular Disease is the leading cause of death in Indigenous and mainstream Australian populations but Indigenous people are affected at younger ages and suffer higher mortality. The Heart Health Project began in 2002 as a collaboration of regional Aboriginal Community Controlled Organisations in the Goulburn-Murray region of South-Eastern Australia with university researchers. Its aim was to develop culturally appropriate, community-directed interventions to improve biomedical, environmental and psychosocial factors that influence health behaviours and outcomes, in particular relating to cardiovascular disease (CVD). Dr Rachel Reilly has written about this project in the Journal of Rural and Tropical Public Health.

Health care improvement broadcasts

The Institute for Healthcare Improvement (IHI) is bringing a 60-minute show every 2 weeks free of charge, that will help health care improvers worldwide stay on top of the latest thinking and strategies for improving patient care. You can tune in “live” through your computer or telephone, or listen to recordings of the broadcast later at your convenience. WIHI is an exciting "talk show" program from IHI, connecting you to the cutting edge of health care improvement. "It’s free, it’s timely, and it’s designed to help dedicated legions of health care improvers worldwide keep up with some of the freshest and most robust thinking and strategies for improving patient care."

You can click here to see the upcoming programs on WIHI.

Health priority areas

The National Health Priority Areas initiative was Australia's response to the World Health Organisation's global strategy Health for All by the year 2000 and its subsequent revision.

You can see the 8 areas of priority and link to the latest information relating to health conditions and diseases. AIHW, Australia's National Agency for Health and Welfare Statistics and Information has recently updated the site.

8570.0 Health Care Services, 2009-10 (First Issue)

The Australian Bureau of Statistics has released a new publication which contains information about the Health Care Services in Australia. Data include: income and expenditure, employment, workforce characteristics, state and regional breakdowns of key data items, performance ratios, and patient/client data.

• Two views of health care services statistics are presented in this publication:
  an industry view in Chapters 1 to 5. This view presents data for businesses and organisations whose predominant activity is the provision of health care services. Industry data are classified according to the Australian and New Zealand Standard Industrial Classification (ANZSIC), 2006 edition (cat. no. 1292.0).


• a General Practitioner practice view in Chapter 1 commentary. This view reflects key performance measures of private GP practices. Practices are identified as a subset of the industry view for GPs and are based on a benchmark provided by the Australian General Practice Network.

The publication is free to download here.

FAST campaign

It is important that everyone knows the signs of stroke and what to do if someone is having a stroke. FAST is a year round campaign that promotes the signs of stroke (Face, Arms, Speech, Time). Health professionals working in a variety of different fields and community groups are endouraged to run an activity to promote the FAST campaign.

See more information at http://www.signsofstroke.com.au/fast.html

Estimates of diabetes prevalence in Australia

The AIHW has just released Diabetes prevalence in Australia: detailed estimates, presenting the most up-to-date assessment of the number of people with diagnosed diabetes in Australia based on self-reports to the Australian Bureau of Statistics' 2007-08 National Health Survey.

The number of people with diabetes is presented by diabetes type, age, sex, state of usual residence and remoteness. In those years an estimated 898,800 Australians had been diagnosed with diabetes (excluding gestational diabetes) at some time in their lives.

Parenting and mental illness

How do Australians with a mental illness fare when they become parents? How well are they supported during pregnancy and the early years – by maternal and child health services and by mental health services – and what action is needed to improve care?  Parenting and mental illness : the early years, is a briefing paper by Sane Australia which tries to address some of these issues.  The paper concludes that much more can be done for this group as they receive little extra help with planning and preparation for parenthood than the general population.

Population ageing and ambulance services

Another MJA article this month is, The challenges of population ageing: accelerating demand for emergency ambulance services by older patients, 1995–2015. (MJA 2011; 194: 574–578). The authors, (Judy A. Lowthian et al) write that the transport of older patients by ambulance has a significant impact on acute hospital capacity because of high admission rates and long lengths of stay. Resultant pressure compromises access, quality of care and patient safety, with emergency department congestion and overcrowding reported regularly. This study concentrates on the impact to the ambulance services themselves of an ageing population.

About 13% of the population in the United Kingdom, United States and Australia are currently aged over 65 years. It is projected that this will increase to 25% over the next 25 years, with the proportion aged over 85 years rising from 1.6% to around 5%. The authors aimed to measure the growth in emergency road ambulance transportations in metropolitan Melbourne since 1995, the impact of population growth and ageing on these services, and to forecast demand for these services in 2015.

Hospital use in the last year of life.

Hospital and emergency department use in the last year of life : A baseline for future modifications to end-of-life care (MJA 2011; 194: 570–573),  by Lorna K. Rosenwax and others, has recently been published in the Medical Journal of Australia.  The study looked at a group of people in Western Australia, for whom death from cancer or one of another nine conditions was an expected outcome. The authors speculated that inappropriate use of hospital and emergency facilities could indicate a lack of community resources for some people, and that “quality of death” could be improved with better planning.

Wind turbines and health

A year ago this Blog linked to an NHMRC research report called Wind turbines and health : a rapid review of the evidence. The report focussed on concerns in the current literature regarding the adverse health impacts of infrasound, noise, electromagnetic interference, shadow flicker and blade glint produced by wind turbines.

Now the issue is revisited as a Senate committee investigating the effects of wind farms on health has found some people living near turbines have suffered ill effects. But the committee, which received more than 1,000 submissions, also says there is no conclusive link. In it's report, The Social and economic impact of rural wind farms, it handed down seven recommendations to the Federal Government, including commissioning more research and installing an independent arbitrator to deal with complaints.