Survival Guide to Summer

The  ABC Health & Wellbeing website has put together a selection of content to will help guide you through the Christmas and New Year season. An example of some of the topics include: SPF50+ sunscreens and how well do they protect you; Fighting festive stress and conflict; The gift of giving reaps healthy rewards and Making healthy habits stick.

New clinical practice guidelines for the treatment of lung cancer

New clinical practice guidelines for the treatment of lung cancer have been published in an electronic ‘wiki’ format to assist doctors and their patients to make informed treatment choices based on the most current research available. The Clinical Practice Guidelines for the Treatment of Lung Cancer, commissioned and co-funded by Cancer Australia and developed by Cancer Council Australia, revise the treatment section of the 2004 “Clinical practice guidelines for the prevention, diagnosis and management of lung cancer”. The guidelines are available online on Cancer Council Australia’s Cancer Guidelines Wiki:  http://wiki.cancer.org.au

Incontinence in Australia: prevalence, experience and cost

The Australian Institute of Health and Welfare has released a paper reporting  on the 316,500 people who experienced severe incontinence in 2009, according to the Australian Bureau of Statistics' Survey of Disability, Ageing and Carers. In 2009, the number of people who always needed help or supervision with their bladder or bowel control was 144,400. About 96,100 people with disability aged 10 and over living in households (2.7% of the total) and 99,700 people living in cared accommodation (63.2%) used continence aids, irrespective of their level of incontinence.
Click here to download the report.

End of Life

The following resources are available for End of Life on the Clinical Ethics Website: Advance Care Directives; Autopsies; Euthanasia and Assisted Suicide; Post Coma Unresponsiveness; Refusal of Life Sustaining or Life Saving Treatment; and Withdrawing or Withholding Treatment: Futility, Best interests and Unjustifiable Burdens.
The Clinical Ethics website is a joint  project for Values, Ethics and the Law in Medicine and the Centre for Health Governance, Law and Ethics at Sydney Law School, University of Sydney.

Hope & Hurdles resource for women with secondary breast cancer

Breast Cancer Network Australia (BCNA) has launched a second edition of Hope & Hurdles, the free and comprehensive information resource for women with secondary breast cancer.
"Originally developed in 2007, the second edition includes new and updated information and a series of optional booklets that women can order according to their individual needs. This allows women to access information relevant to them when they want it. Hope & Hurdles also includes brochures, magazines and CDs that offer information, support and hope for women and those around them. For more information click here.

Ectopic pregnancy and miscarriage

This clinical guideline offers evidence-based advice on the diagnosis and management of ectopic pregnancy and miscarriage in early pregnancy (ie, up to 13 completed weeks of pregnancy). Published by the National Institute for Health and Clinical Excellence (NICE) it is the latest in a collection of pregnancy-related guidelines from NICE.
Other pregnancy-related clinical guidelines published by NICE include antenatal care, pregnancy and complex social factors and multiple pregnancy. NICE has also published a quality standard on antenatal care.
Clinical guidelines, CG154 - Issued: December 2012

Telltale Signs of Progress in the Management of Thrombotic Thrombocytopenic Purpura

Thrombotic Thrombocytopenic Purpura (TTP) is a rare blood disorder characterized by microscopic clots throughout blood vessels in the body. TTP can cause catastrophic damage if not quickly diagnosed and treated because sufficient oxygen is unable to reach vital organs. This video discusses the most recent research on current therapies to help manage TTP. ( from Transfusion News http://transfusionnews.com/)

Serious childhood community injury in New South Wales 2009-10

More than 23,000 children and young people in New South Wales were hospitalised because of an injury in 2009-2010, according to a report released  by the Australian Institute of Health and Welfare (AIHW) and the NSW Commission for Children and Young People. The report, Serious childhood community injury in New South Wales 2009-10, provides information on hospitalised injury of NSW children (aged 0-17) between 1 July 2009 and 30 June 2010. It also provides information on long-term trends.
 Falls were the most commonly reported cause of hospitalised injury (39% of cases), and these frequently involved playground equipment. Transport injuries were also common (14%).

Database of cases website

Biomed Central has launched their Cases Database website to capture and aggregate medical knowledge from case studies. It includes all the cases from 100 journals such as Journal of Medical Case Reports and  BMJ Case Reports, currently amounting to over 11 000 cases and continuously updated. You can search the cases by diagnosis, intervention, medication, age, sex, ethnicity or symptoms.  The database is intended to be used for teaching, learning, researching and generating hypotheses, and practitioners are encouraged to submit their own case studies for peer review and possible inclusion.

Economic and social impact of eating disorders

The Butterfly Foundation has published Paying the price : the economic and social impact of eating disorders, in which it reveals that there are more than 913,000 people in Australia with eating disorders in 2012 and that this amounts to a socioeconomic cost of $69.7 billion.

The report estimated that mortality rates are almost twice as high for people with eating disorders compared to the general population, with up to 1828 deaths from eating disorders in 2012 (515 males and 1313 females).  Around 4% of the Australian population have eating disorders and of these, 47% have a binge eating disorder and 64% are female. 

Cancer in Australia : an overview

This AIHW report has received much media attention over the past couple of weeks.  Cancer in Australia : an overview 2012, presents the latest available information on incidence, mortality, survival, prevalence, burden of cancer, hospitalisations and national cancer screening programs.   The main findings of the report include the estimate that more than 120,700 Australians will be diagnosed with cancer in 2012, most commonly prostate, bowel and breast cancer. For all cancers combined, the incidence rate increased by 12% from 1991 to 2009, but the mortality rate decreased and survival improved over time. Cancer outcomes differ by Aboriginal and Torres Strait Islander status, remoteness area and socioeconomic status.
For those short of time, the key points and trends of the whole report are presented in a summary paper, Cancer in Australia : in brief 2012.

National report card on mental health and suicide prevention

A Contributing life : the 2012 national report card on mental health and suicide prevention has been published recently by National Mental Health.  It examines how Australian looks after the estimated 3.2 million Australians each year who live with mental health difficulties, as well as their families and carers.   The report shows that although Australia leads the world in progressive mental health policy, it falls down in delivery.  Ten specific recommendations are made, such as: 

• reducing the early death of Australians with severe mental illness and improving their physical health

• minimising the use of seclusion and restraint

• increasing access to mental health services from 6-8 to 12 per cent of Australia’s population

• making the mental health of Aboriginal and Torres Strait Islander peoples a higher priority

• stopping people from being discharged from mental health services into homelessness or unstable homes

• increasing the employment rates of people with mental illness and paying greater attention to supporting them at work

• increasing access to home based visiting to support families and children

• providing effective, local interventions to prevent suicide.

Diabetes among young Australians

Diabetes Among Young Australians  has just been published by the AIHW and is the first report from the National Centre for Monitoring Diabetes to examine the management and impact of diabetes in youth in Australia.  In 2010 about 31,300 Australians aged 0-30 years with diabetes were registered with the National Diabetes Service Scheme.  79% of them had Type 1 diabetes.  The report looks at how young people are managing this condition, how they use health services and the diabetes-related health problems they experience.

Quick resources for depression in young people

Following the development of the NHMRC-approved Clinical Practice Guidelines for Depression in Adolescents and Young Adults in 2011, beyondblue has produced several quick and easy reference guides for health professionals.  The new resources include:

• Depression in young people - executive summary
• Assessment and management of depression in your people
• Engaging young people in health care
• Depression in young people : a desktop guide

Work-related Traumatic Injury Fatalities, Australia 2010–11

Safe Work Australia recently released the Work-related Traumatic Injury Fatalities, Australia 2010–11 report. The report found that 374 people died from a work-related traumatic injury in 2010–11. Of these 220 workers (59 percent) died from injuries incurred at work; 110 workers (29 percent) died from an incident while travelling to or from work and 44 people (12 percent) died as a bystander to someone else’s work activity.
Click here or go to www.safeworkaustralia.gov.au

Australian Health Survey: First Results, 2011-12

First results from the Australian Health Survey have some good and bad news; smoking rates continue to fall, as do rates of drinking at risky levels, but the number of people who are overweight and obese continues to rise. First Assistant Statistician at the Australian Bureau of Statistics, Dr Paul Jelfs, said the 2011-12 Australian Health Survey was the largest checkup on the nation's health ever undertaken.
"Compared to four years ago the proportion of overweight adult Australians has increased by more than two percentage points, meaning that nearly two-thirds (63 per cent) of the population are now classified as overweight or obese," Dr Jelfs said.

This publication contains first results from the 2011-13 Australian Health Survey, including health risk factors (such as alcohol consumption, tobacco smoking and Body Mass Index); long-term health conditions; mental health and wellbeing; and physical activity. Information is presented for Australia and the states and territories.

4364.0.55.001 Australian Bureau of Statistics

World Aids Day

1 December is World AIDS Day for 2012.  This year's theme is "HIV is still here". The World AIDS Day website is useful for lots of up to date information on the disease, including the fact that although the number of new HIV diagnoses in Australia has been stable for the past five years, there were still 1137 new infections diagnosed in 2011, an increase of 8.2% from 2010.

A useful article on recent global trends in HIV/AIDS was published this year in the journal AIDS.  "The evolving epidemiology of HIV/AIDS" by de Cock and others describes the challenge of the epidemic, with about 34 million people living with HIV worldwide, and nine countries in southern Africa accounting for less than 2% of the world's population representing about one third of global HIV infections.  Ask at your health library for a copy of the full text of the article.
AIDS 26 (10), 19 June 2012 : 1205-13.  

International profiles of health care systems

International Profiles of Health Care Systems: Australia, Canada, Denmark, England, France, Germany, Japan, Iceland, Italy, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United States has been published by the Commonwealth Fund.

Each overview covers health insurance, public and private financing, health system organisation, quality of care, health disparities, efficiency and integration, care coordination, use of health information technology, use of evidence-based practice, cost containment, and recent reforms and innovations.  Summary tables compare overall results on such factors as health care spending, hospital utilisation, patient safety, disease prevention and public views. 

Patient experiences 2011-12

The Australian Bureau of Statistics conducts a Patient Experience Survey annually, collecting national data on the access and barriers to health services such as general practitioners, medical specialists, dentists, pathology tests and hospital experiences.  Patient experiences in Australia: summary of findings 2011-12 is the latest report.

Overall levels of satisfaction with health professionals was high, with around 80% of people reporting that they always or often felt that they listened carefully, showed respect or spent enough time with them.  Dental professionals scored particularly well.

Changes in life expectancy 1998-2009

This report, Changes in life expectancy and disability in Australia 1998-2009 from AIHW shows that older Australians are living longer without severe or profound limitations in their daily activities.  However, the ageing of the population is leading to a larger number of people with disability and activity limitation. 

From 1998-2009, life expectancy at birth rose from 75.9 years to 79.3 years for males and from 81.5 years to 83.9 years for females.  Boys born in 2009 could expect to live an average 61.1 years without disability (girls 64.3), and another 17.7 years with disability (girls 19.6), including 5.5 with severe or profound activity limitation (girls including 7.5 years with severe or profound activity limitation.

Science of immunisation - Q and A

The Australian Academy of Science has released "The Science of immunisation : questions and answers" in an attempt to address "confusion created by contradictory information in the public domain."  It explains the current situation in the science of immunisation, including where there is scientific consensus and where there is uncertainty.  The document discusses the meaning of the words vaccine and immunisation, and discusses the benefits and the safety of vaccines.

The publication was endorsed by the Royal Australasian College of Physicians and the Australian Medical Association.

Childhood injury trends report

Trends in hospitalised childhood injury in Australia 1999-07 is a report just released by the AIHW providing summary data on trends in three age groups: 0-4, 5-9 and 10-14 for each year of the study.  Almost half a million children were hospitalised as a result of an injury during this period, with boys outnumbering girls by 2 to 1.

Falls were the main cause of hospitalised injury, and transport-related injuries were also common.  The only category where girls outnumbered boys was in intentional self-harm (3,514 girls being hospitalised for this and 837 boys.) 

Learning Guide for allied health professionals

HETI (Health Education & Training Institute) has produced The Learning Guide : a handbook for allied health professionals facilitating learning in the workplace.  "It provides information and guidelines based upon published evidence that supports effective methods of promoting education, learning needs and professional development of allied health professionals working in clinical settings, to contribute to the safey and quality care of patients."

The Learning Guide follows the earlier production by HETI of The Superguide - a handbook for supervising Allied Health professionals.

Impact of work hours on Australia's health

An unhealthy obsession? The impact of work hours and workplace culture on Australia's health is a new report from the Australia Institute.  According to authors Denniss and Baker, Australians work some of the longest hours in the developed world.  For many of us, our work-related stress is due more to the mismatch between desired and actual hours at work, rather than the number of hours worked.  Australian workers would also be happier if there was more flexibility in their work arrangements, and this is true for workers across the earning spectrum. 

More than 3.2 million Australians report that their working conditions are a cause of stress and anxiety, 2.9 million have experienced a loss of sleep as a result of their working arrangements and 2.2 million Australians report that their work has an adverse impact on their personal relationships.

Workplace barriers for people with hearing loss

Labour force activities, barriers and enablers for people with a hearing loss : the workforce barriers and incentives study has just been published by the Australian 

Centre for Economic Research on Health.  It considers, by way of survey, 

the problems that people who want to work confront when they have a hearing loss. The results indicate that some of those barriers can be overcome by support in the workplace from colleagues and access to appropriate equipment and support services.
The report concludes, "Measures that remove or ameliorate the barriers that people with a hearing loss currently face present an opportunity to improve participation rates and hours worked in this subpopulation. This is likely to be particularly important as the working age population itself ages and the prevalence of hearing loss grows in the working age population."

Perioperative management of HIV infected patients

Perioperative Management of HIV Infected Patients is a recently released guideline from the New York State Department of Health.  Some of the considerations when formulating the guideline were the risk to the surgical team, as well as pre and postoperative assessment of hepatic and renal dysfunction, coronary artery disease and cardiac risk, coagulopathy, thrombocytopenia, and neutropenia, active alcohol or substance use, history of prior infection with MRSA, and any drug allergies the patient may have.

Health workforce 2025

Health Workforce 2025 (HW 2025) provides Australia’s first major, long-term national projections for the health workforce out to 2025.  Volumes 1 and 2 dealt with doctors, nurses and midwives, while Volume 3 examines individual medical specialties in Australia.  The reports found that reform is essential to ensure a sustainable, affordable health workforce for the future.   

Several key projections were made that indicate problems if no changes take place by 2025.  These include a highly significant shortage of nurses, a shortage of doctors, a shortage of postgraduate medical training places, and an uneven distribution of the medical workforce across Australia.  Issues raised in Volume 3 included the fact that although the number of medical specialists is increasing, the workforce is not evenly distributed, and there are not enough generalists.  Psychiatrists and Radiation Oncologists are the most at-risk specialties.

Download Health Workforce 2025 - Volume 1  (.pdf)

Download Health Workforce 2025 - Volume 2 (.pdf)

Download Health Workforce 2025 - Volume 3 (.pdf)

Antibiotic Awareness Week

Antibiotic Awareness Week has been promoted globally this week as an initiative aimed at combating the development of  antibiotic resistance, which is an enormous health threat.  If you work in NSW Health you would be aware of the Clinical Excellence Commission's drive this week in "Quality Use of Antimicrobials in Healthcare".

The Australian Commission on Safety and Quality in Healthcare also provides some good information on Antibiotic Awareness Week on their website, highlighting concerns about inappropriate use and overuse of antibiotics.

For a simple summary on superbugs, antibiotics and resistance, we recommend the ABC's Health and Wellbeing page, "What are superbugs?".

Journal issues on vaccination and infectious disease

Two journals have this month published special issues on vaccination and the control of infectious disease.  Both are open access, so all articles are freely available.

Clinical Microbiology and Infection has a supplement, The Impact of Vaccines on Public Health.  Review articles in the supplement are divided into the History of Vaccination, Pneumococcal Disease, Vaccination against Viral Diseases, Vaccination in Specific Situations and Future Directions for Vaccination.

International Nursing Review has published a virtual issue, The Prevention of Infectious Diseases and their Consequences : still a policy priority for nurses.  There are eight articles here, covering such issues as the papillomavirus vaccine, influenza, diarrheal disease, MRSA, hepatitis and occupational exposure to HIV.

Clinical Microbiology and Infection, Oct 2012 18 (Suppl s5) : 1-122.
International Nursing Review, virtual issue, October 2012.

Meta Analysis of Hospital in the Home

A meta-analysis of “hospital in the home” has been published this month in the Medical Journal of Australia by Caplan and others.  The paper analysed 61 randomised controlled trials comparing HITH care with in-hospital treatment for patients over 16 years of age. The authors report that HITH care led to reduced mortality, readmission rates and cost and that patient satisfaction was higher in HITH in 21 of 22 studies, and carer satisfaction was higher in six of eight studies where this was examined.

Medical Journal of Australia 2012;197(9):518-519. (Open access)

Nursing and multiple sclerosis - Guideline

The American Association of Neuroscience Nurses has just published a new guideline:  Nursing Management of the Patient with Multiple Sclerosis.

Prescriptions for obstructive airway disease - AIHW report

Medications prescribed for people with obstructive airways disease: antibiotics and inhaled corticosteroids, is an AIHW report which focuses on the appropriate use of certain medications for the management of obstructive airways disease, including asthma and chronic obstructive pulmonary disease (COPD). Appropriate use of medications is important in maximising health benefits for patients, minimising the negative effects of medications, and controlling health costs.  

Data in this report suggest that antibiotics are commonly used among patients with asthma and COPD, and that supply patterns for inhaled corticosteroids are often not consistent with treatment guidelines for the management of these conditions.

Heat and climate change implications for health

Socio-cultural reflections on heat in Australia with implications for health and climate change adaptation is a paper from Jane Dixon and others at the National Centre for Epidemiology and Population Health.  The authors explored ways in which vulnerable sub-populations adapt their personal behaviour to cope with heat.
The warm climate of Australia and the increase in heat related deaths indicates that Australians need to be better prepared for coping with extreme heat. A number of methods of dealing with heat were discussed in the paper, but it seemed that the reliance on air conditioning was universal, which itself contributes to carbon emissions and thus fostering climate change conditions such as further heatwaves.

Ageing in the 21st Century - UN Report

Ageing in the Twenty-First Century : A Celebration and A Challenge is a landmark publication from the United Nations Population Fund and HelpAge International.  It represents a collaboration of over 20 United Nations entities and major international organizations working in the field of ageing and reviews policies and action taken by governments and other stakeholders since the Second World Assembly on Ageing in 2002. In addition to providing many inspiring examples of innovative programs that address population ageing and the concerns of older persons, the report captures the voices of some 1300 older persons themselves.

The report concludes with ten priority areas for maximising the opportunity of ageing populations, including the need to recognise the inevitability of ageing populations and to ensure all stakeholders are adequately prepared for the growing number of older persons.

When is medical treatment futile? ABC Health Report

Many doctors want to lift the lid on a phenomenon they say is worsening the suffering of many dying Australians. It's called 'limited benefit' or 'futile medical treatment', where patients with a poor prognosis are given aggressive drug therapy or surgery.  This special edition of ABC Radio National’s Health Report opened debate on this issue, and the possibility that many specialists are not considering palliative care early enough.

Dr Peter Saul, Senior Intensive Care Specialist and Ethical Consultant with the New South Wales Health Department discussed the problem of initiating a conversation with dying patients which includes “'do you really want us to do all of this and have you spoken to your family and what were your expectations' [which] becomes a very long conversation, whereas the 'sign here, we're going to operate' is five minutes.”   He believes that doctors don’t always tell patients the full story, but that they mean well and are not solely responsible for the problem of aggressive treatment being given to uninformed, dying patients.  “My own personal view is that Australia is a very, very death-denying society and that this discourse doesn't take place very much.”

Dr Steve Hambleton, President of the AMA, agreed to a certain extent, "When we present options to patients there is a tendency to ... talk about the people who do survive, not really about the reality  So we do tend to put things in a very optimistic way and we need to be realistic, and some people are going to reach that long tail, the survival tail, but the majority won't."  

The program includes interviews with other specialists, including those in palliative medicine, and also covers the legal and ethical viewpoints on this debate.  The link above will take you to the transcript or podcast, or you can listen online.

Workplace screening programs for chronic disease prevention

Workplace screening programs for chronic disease prevention : a rapid review has just been published by Bill Bellew and others at the University of Sydney for the Sax Institute.  The authors used evidence retrieved from the main databases of biomedical and health economic literature published to March 2012, supplemented with relevant reports and they found strong evidence of effectiveness of HRAs (when used in combination with other interventions) in relation to tobacco use, alcohol use, dietary fat intake, blood pressure and cholesterol.  They also found sufficient evidence for worksite programs to control weight issues.  They concluded that these programs had a favourable impact on the use of healthcare services and financial return for the employer.   

Drinking cultures and social occasions report

Drinking cultures and social occasions : alcohol harms in the context of major sporting events, published by VicHealth, explores this subject in terms of general patterns, gender patterns and age patterns. A range of alcohol-related harms were considered, including acute intoxication requiring medical attention, assaults, and motor vehicle accidents.  

The peak months of the year for ambulance attendances, emergency department presentations, and hospital admissions attributed to acute alcohol intoxication were November and December, with February also being identified as a peak month among males. Consistent with the literature, varying effects were noted for major sporting events. For all groups examined, elevated cases of alcohol intoxication occurred on the day of the Melbourne Cup, and also for all groups except females on the day of the AFL Grand Final and the event of the Commonwealth Games. Numbers of ambulance attendances for acute intoxication were significantly lower than expected on the day following the Melbourne Cup for all patients, and this was driven by the trend among females.

‘It’s been a long hard fight for me’: the Stolen Generations and Narratives of Poor Health in Australia 1883-2009

Health, according to the World Health Organisation (WHO), can be defined as ‘a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity.’ Using this definition of health, and others, as guiding principles, this thesis, by Lisa Vicki Campbell of the University of Waikato in Hamilton, New Zealand, takes a thematic approach in order to demonstrate how nineteenth and twentieth-century Australian government policies have influenced the health of Indigenous Australians today.

The four key themes investigated are alienation, mental illness, alcohol abuse, and crime. By weaving the narratives taken from a number of published oral interviews, testimonies from various Australian reports, and other edited collections, this thesis argues that from the perspective of numerous members of the Stolen generations, the forcible removal of Aboriginal children and the subsequent feelings of alienation produced by removal, have had significant and on-going implications for the current state of poor health within Aboriginal and Torres Strait Islander communities. (APO 29/10/12)

The Menzies Nous Australian Health Survey 2012

The Third Biennial National Survey conducted by the Menzies Centre for Health Policy and Nous Group (Nous) has been published, providing key findings about the views held by Australians on their own health, on the Australian healthcare system, and aged care services. Previous surveys were conducted in 2008 and 2010.The Australian Health Survey 2012 was conducted via a phone interview of 1200 people in July 2012. Interviews were conducted by telephone using random digit dialling Computer Assisted Telephone Interviewing (CATI).To enable analysis of trends since 2008, a number of questions regarding the health of Australians and use of the health care system were consistently asked in 2008, 2010 and 2012. To reflect changes in the health care system, some minor amendments and refinements were made to these questions in the 2012 survey.  A number of questions were also asked for the first time this year – particularly those regarding Australian perspectives of the aged-care reforms. Data from all surveys have been post-weighted by age, sex, state and education to reflect the population distribution.

Australian Health Survey - first results

The first results released by the Australian Bureau of Statistics from the Australian Health Survey 2011-12 have some good and bad news; smoking rates continue to fall, as do rates of drinking at risky levels, but the number of people who are overweight and obese continues to rise.
The proportion of overweight adult Australians has increased to the point where almost 63% of the population are now classified as overweight or obese.  70% of men, 56% of women and 25% of children are overweight or obese.  Results released this week from the Australian Health Survey are the first in a series of results that will be release progressively over the next 18 months.

Picture of Australia's children 2012

A picture of Australia's children 2012 provides the latest information on how Australia is faring according to key indicators of child health, development, and wellbeing. Deaths rates for infants and children have declined since 1986, rates of risky drinking and smoking among children aged 12-14 are down, and most children achieve above the minimum standards for reading and numeracy.

But there is still room for improvement. Almost one-quarter of children are developmentally vulnerable at school entry, and Aboriginal and Torres Strait Islander children and children in socioeconomic disadvantaged areas are likely to fare worse across a broad range of indicators. 

Measuring the quality of allied health services in Australia

'Measuring the quality of allied health services in Australia: Is it a case of "the more we learn, the less we know"?' has recently been published in the Journal of Healthcare Leadership.
This evidence-informed analytical review outlines factors that should be considered by allied health leaders when measuring allied health service quality.  It describes allied health services in detail and discusses the difficulties when making these measurements, taking into account the locations and range of services provided and the complexity of the allied health discipline-mix. The authors emphasise the importance of strong, visionary, and collaborative leadership to ensure that allied health activities and outcomes are both measured and reported in an effective and efficient fashion.

Grimmer-Sommers K, Milanese S, Kumar S. (2012). Journal of Healthcare Leadership, 4, 71-81

Assisted reproductive technology report

Assisted reproductive technology in Australia and New Zealand 2010 has been released by the AIHW.  The report indicated that in 2010, there were 61,774 assisted reproductive technology (ART) treatment cycles performed in Australia and New Zealand. Of these, 23.9% resulted in a clinical pregnancy and 18.1% in a live delivery. There were 12,056 liveborn babies following ART treatments in 2010.  A continuing trend in ART treatment in Australia and New Zealand has been the reduction in the rate of multiple birth deliveries, achieved by clinicians ad patients shifting to single embryo transfer.  

General health checks in adults - Cochrane review

General health checks in adults for reducing morbidity and mortality from disease is an interventional review recently published by the Cochrane Library.  The aim was to determine whether general health checks do more harm than good, emphasising patient-relevant outcomes such as morbidity and mortality. Health checks were defined as screening general populations for more than one disease or risk factor in more than one organ system. The authors noted that general health checks are unlikely to be beneficial as they did not reduce morbidity or mortality, overall or for cardiovascular or cancer causes, although the number of new diagnoses was increased.  

Norman Swan interviewed the lead author, Lasse Krogsboll, on ABC Radio National's Health Report about this last week.  You can read the transcript or listen to the podcast here.

Krogsbøll LT, Jørgensen KJ, Grønhøj LC, Gøtzsche PC. (2012). Cochrane Database of Systematic Reviews, Issue 10. Art. No.: CD009009, DOI: 10.1002/14651858.CD009009.pub2

Oral health reports

The Australian Institute of Health and Welfare has released two new reports on oral health care, using data from the 2010 National Dental Telephone Interview Survey:

Families and their oral health provides information on the oral health and oral health impacts experienced by Australian children and seeks to determine if this experience is closely related to the oral health of their parents. Additionally, the report explores the role family circumstances play in children's experience of oral health. 

Chronic conditions and oral health reports on the impact of oral conditions on people with a chronic condition including asthma, cancer, heart disease, diabetes, arthritis, stroke, kidney disease, high blood pressure and depression. The report found that people with a chronic condition were more likely to experience toothache, be uncomfortable with their oral appearance, avoid certain foods due to oral problems and to experience orofacial pain. They were also more likely to have fewer than 21 teeth, making it difficult to chew food. 

Ward rounds - best practice guidelines

Ward rounds in medicine: principles for best practice has just been published by the Royal College of Physicians with the Royal College of Nursing.  It sets out core recommendations and principles for best practice for conducting medical ward rounds, including their structure, preparation and scheduling, as well as patient participation and protection, nursing involvement, the use of safety checklists and discharge planning. 

It calls for the multidisciplinary team – doctors, nurses, pharmacists, therapists and allied health professionals – to be given dedicated time to participate, with clarity about individual roles and responsibilities during and after ward rounds.  

Australian Clinical Trials website

Patients suffering chronic diseases will benefit from the launch of a new website that offers easier access to clinical trials of new drugs, treatments and medical procedures. Minister for Health, Tanya Plibersek recently launched the Australian Clinical Trials website in response to the needs of consumer groups, the pharmaceutical industry and research institutions. 
 
The website includes explanations of the clinical trial process; contact details for trials; a section for trial sponsors; real stories from patients, doctors and researchers, and a section for researchers on ethics, legislation and getting started.

Palliative care services in Australia

This inaugural report on palliative care services in Australia provides detailed information on the national responses to the palliative care needs of Australians.  Details from a range of data sources for 2009-10, and where available 2010-11, are presented, as are changes over time.

Since 2000-01, the number of palliative care separations reported in public and private hospitals has increased by 51% to almost 56,000 in 2009-10, and almost $3 million in MBS benefits was paid for palliative medicine specialist services in 2010-11. Over the 5 years to 2010-11 the amount of benefits paid on palliative medicine specialist services subsidised through the MBS has more than doubled.

There were 172 specialist palliative medicine physicians and 5173 nurses working principally in palliative care in Australia in 2009.

Landmark study on IV fluids

A landmark study by Australian and New Zealand researchers, CHEST (The Crystalloid vs Hydroxyethyl Starch Trial) has found that a widely used starch fluid for resuscitation of patients in intensive care units provides no clinical benefit and its use results in increased acute kidney failure (haemodialysis) when compared to normal saline.

Published in the New England Journal of Medicine, the study randomly assigned 7000 patients who had been admitted to an intensive care unit to either the starch fluid or the normal saline. The primary outcome was death within 90 days. Secondary outcomes included acute kidney injury and failure and treatment with renal-replacement therapy.  The results of the trial showed that, in patients in the ICU, there was no significant difference in 90-day mortality between patients resuscitated with 6% HES (130/0.4) or saline. However, more patients who received resuscitation with HES were treated with renal-replacement therapy.

Myburgh, J.A. et al “Hydroxyethyl Starch or Saline for Fluid Resuscitation in Intensive Care” NEJM October 17, 2012DOI: 10.1056/NEJMoa1209759

BreastScreen monitoring report

The Australian Institute of Health and Welfare has just released BreastScreen Australia monitoring report 2009-10.  BreastScreen Australia aims to reduce illness and death resulting from breast cancer through organised screening of women. This report is the latest in an annual series that presents national statistics monitoring the program against performance indicators. More than 1.3 million women in the target age group of 50-69 were screened in 2009-2010, a participation rate of 55%. Breast cancer mortality is at a historic low, at 43 deaths per 100,000 women.

Population Health Research Network (PHRN)

The Population Health Research Network (PHRN) has been stablished with the backing of the Australian Government (as part of the National Collaborative Research Infrastructure Strategy) and is supported by every Australian state and territory.  The PHRN will enable existing health data from around Australia to be brought together and made available for health and health related research purposes. Health care planners, providers and policy makers will be able to use this research to respond more effectively to the changing needs of the Australian population.

Healthy lifestyle workers' web resource

A new on line portal to support Australia's Healthy Lifestyle Workers was recently launched by the Australian Indigenous HealthInfoNet.  Healthy Lifestyle Workers are employed across Australia as part of the Australian Government's Closing the gap - Indigenous chronic disease initiative.   The resources on this site The resource aim to provide the healthy lifestyle workforce with access to quality information, including key facts, publications, resources, programs and organisations on a range of topics such as tobacco use, nutrition, physical activity, diabetes, and kidney health.

Mental health services in Australia

Mental health services in Australia - in brief 2012 provides an overview of the national response to the mental health needs of Australians. It includes information on mental health service provision, available mental health resources and the changes that have occurred in these over time.

Estimates from the 2007 National Survey of Mental Health and Wellbeing (SMHWB) suggest that 7.3 million Australians (45% of the population aged 16–85) will experience a common mental disorder (a mood disorder, such as depression; anxiety or a substance use disorder) over their lifetime. Each year, 20% of the population in this age range, or 3 million Australians, are estimated to experience symptoms of a mental disorder. The second National Survey of People Living with Psychotic Illness conducted in March 2010 (Morgan et al. 2011) estimated that almost 64,000 people in Australia had a psychotic illness, most commonly schizophrenia, and were in contact with public specialised mental health services each year.

Health statistics for NSW

Health Indicators for NSW, authored by Talina Drabsch and published by the NSW Government, contains a selection of health statistical indicators in New South Wales and aims to provide a snapshot of health trends.  There is a focus on the overall picture in NSW, with breakdowns by local health districts, and, where relevant, comparisons with other Australian States and Territories.  Topics include statistics on births, life expectancy, disability, death, substance use, mental health, immunisation, health expenditure and hospital separations.

Private Lives 2: the Second National Survey on the Health and Wellbeing of Gay, Lesbian, Bisexual and Transgender (GLBT) Australians

Private Lives 2 (PL2) is a report on the second national survey of the health and wellbeing of gay, lesbian, bisexual, and transgender (GLBT) Australians. The first Private Lives (PL1) was released in 2006 and was, at that time, the largest survey of its kind conducted anywhere in the world. In 2011, 3,835 GLBT respondents successfully completed PL2. PL2 was an on-line survey publicised, nationally, and backed up by some hard copies of the survey which were distributed to GLBT seniors organisations across the country. The questionnaire consisted, primarily, of forced-choice (quantitative) questions but included a small number of open-ended or qualitative questions. The authors are William Leonard and others.

The project was supported by beyondblue with funds from The Movember Foundation, with additional funds provided by the Victorian Department of Health and a La Trobe University faculty grant. The project was managed jointly by Gay and Lesbian Health Victoria (GLHV) and the Australian Research Centre in Sex, Health and Society (ARCSHS) La Trobe University. (APO 30/4/12)

Footprints in Time - the Longitudinal Study of Indigenous children (LSIC)

The study aims to improve the understanding of, and policy response to, the diverse circumstances faced by Aboriginal and Torres Strait Islander children, their families and communities. The Footprints in Time study was conducted by the Department of Families, Housing, Community Services and Indigenous Affairs (FaHCSIA) under the guidance of the Footprints in Time Steering Committee, chaired by Professor Mick Dodson AM. The study aims to improve the understanding of, and policy response to, the diverse circumstances faced by Aboriginal and Torres Strait Islander children, their families and communities. (APO 18/9/12)
The study was broken up into three waves:
Wave 1: topics include family life, growing up strong, learning and doing, and strong souls and safe communities.
Wave 2: Changes in family life structure and new topics such as child support, stolen generations and pre-school.
Wave 3: This report uses a measure called the Level of Relative Isolation (LORI) to describe the geographical characteristics of families in the study

Addressing Uncomfortable Issues: the Role of White Health Professionals in Aboriginal Health

This research by Annabelle Wilson investigated the role of white health professionals in addressing Aboriginal health in South Australia. Set within the discipline of nutrition and dietetics and the area of obesity prevention, it explored the practice of White health professionals from the point of view of Aboriginal and White workers. This research, currently in the form of an unpublished Doctor of Philosophy thesis, arose from practice dilemmas the author experienced as a dietitian working in rural and remote South Australia. The setting for this research was the eat well be active Community Programs, a community-based, childhood obesity prevention program in South Australia. In order to conduct ethical research, the author worked closely with Aboriginal community members and workers, through building and maintaining relationships and activities of reciprocity.

This research identified that there are a number of elements to the practice of White health professionals that make it ideal when they are working with Aboriginal communities. However, such ideal practice does not always occur and this research sought to identify why. The organisation, profession and individual were identified as systems within the wider system of Aboriginal health. In summary, this research identified that moving forward in Aboriginal health requires White health professionals to look at themselves, which generally requires them to address uncomfortable issues. (APO 11/10/12)

Supporting Older People who are Experiencing Mental Distress or Illness

The Benevolent Society has released the seventh in its series of community aged care Research to Practice Briefings.  Briefing 7, Supporting older people who are experiencing mental distress or illness, reviews Australian and international research evidence on the symptoms and treatments of mental illness in older people to provide guidance for community care practitioners in their day-to-day work of supporting older people. Mental distress or illness is not a normal part of ageing.  However, like people of any age, older people can be vulnerable to mental illness. This Briefing was developed in partnership with the National Ageing Research Institute (NARI). (APO 30/08/12)

Consumer Participation in the Health System

The following 2012-13 Victorian  Auditor General report provides details on consumer participation within the Victorian health care system. Consumers should be meaningfully involved in decision-making about their healthcare and treatment, and broader health policy, planning and service delivery. There is genuine commitment and effort from the Department of Health, and health services,  to facilitate meaningful consumer participation. The department has led implementation of consumer participation through strong policy direction and this has translated into appropriate policies, systems and activities in the four audited health services. Implementing consumer participation is relatively recent and a challenging process, and health services do not always provide sufficient staff training, resources or support to integrate consumer participation across their organisation. Consequently, achievements both between and within health services vary. (APO 10/10/12)

Women and Food

This discussion paper, Women's Health Issues Paper No. 8, explores various aspects of women’s health relating to food. These include the impacts of nutritional deficiency, the links between nutrition and chronic disease, women’s roles in relation to food, how a woman’s relationship with food affects her psychosocial health and the socio-economic factors that impact on access to nutritious food. Controversy exists in public health and health promotion about the approach and key messages that should be adopted in relation to food-related behaviours and body size to promote ‘health’ and prevent illness for women. It outlines various perspectives in this discourse and highlights some principles for managing health risks of public messages. It  was compiled by Bronwyn Upston from Womens' Health Victoria. (APO 9/10/12)

Targeting Brain, Body and Heart for Cognitive Health and dementia prevention

This report, by Alzheimer's Australia, looks into the current research regarding dementia and Alzheimer's disease prevention and offers ideas for possible future solutions. Prevention of dementia is the ultimate aim of a large, albeit under resourced, international research effort. The success of this effort would have enormous benefits for millions of people and save billions of dollars in health care costs. Conversely, the status quo will see the number of Australians living with dementia soar in coming years. Many more people will experience and seek help for mild cognitive impairment. There are many different forms of dementia, a syndrome caused by brain disease and characterised by declining cognitive function that impairs daily activities.

Dementia can affect memory, language, attention, judgement, planning, behaviour, mood and personality. Mild cognitive impairment does not significantly impair daily activities, but often represents an earlier stage of cognitive decline. There is no cure for the common forms of cognitive decline and dementia, including the most common, Alzheimer’s disease. A cure may only be achieved by prevention, because the diseases that cause dementia begin many years before symptoms become apparent and gradually damage the brain until it can no longer function normally. Intervening early to stop or slow disease progression, before cognitive impairment emerges, offers the best hope of preventing dementia. The disease can now be detected by brain scans or cerebrospinal fluid tests in the preclinical stage, before any cognitive changes occur.  (APO 30/9/12)

Investigating General Practice and Hepatitis B

There is an increasing burden on the community resulting from chronic hepatitis B infection. General Practitioners (GPs) are essential in reducing this burden given strong evidence showing that the early detection, follow-up and treatment of chronic hepatitis B can slow the progression to liver failure and reduce the chance of being diagnosed with liver cancer. The Australian National Hepatitis B Strategy 2010-2013 describes ‘general practice as part of a healthcare team... central to the healthcare experience of people living with chronic hepatitis B.’ Given indications of a less than optimal response to chronic hepatitis B by GPs in Australia, this study conducted qualitative interviews with 26 GPs to identify their understanding of their role, and perspectives on the barriers and challenges to the effective diagnosis and management of chronic hepatitis B in general practice. Authors: Jack Wallace, Behzad Hajarizadeh, Jacqui Richmond and Stephen McNally from the Australian Research Centre in Sex, Health and Society - La Trobe University. (APO 28/5/12)

Child Dental Health Survey Australia 2007

This report, "Child dental health survey Australia 2007 30-year trends in child oral health", describes the state of oral health of Australian children examined by school dental service (SDS) staff in 2007. It also describes trends in oral health of Australian children between 1989 and 2007. The most recent findings are drawn from the 2007 Child Dental Health Survey (CDHS) which analysed the data of 110,014 children aged 4 to 15 from most states and territories. The longer term trends highlight results for children aged 6 and 12 as these are the standard age groups for reporting on dental caries experience in the deciduous and permanent teeth respectively. Due to missing data from Victoria, any comparisons with previous years or international statistics should be made with caution. The figures presented over 30 years are drawn from previous CDHSs and monitoring undertaken by the (then) Commonwealth Department of Health.  (APO 29/5/12)

Smart Technologies for Older People

Addressing the challenges faced by an ageing population, this report discusses how smart technologies can support older people to remain in their homes. It is a systematic review of smart technologies that promote health and wellbeing of older people living at home from the Institute for a Broadband-Enabled Society (IBES). Australia has an ageing population. In 1901 the average life expectancy in Australia was 47 years. By 2025 it will be over 80. In 2050, 25% of Australians will be aged over 65, with 5% over 85. The growing number of older Australians leads to increased demand for aged services in health, social support, transport and housing. The effects of population ageing are enduring, placing increasing pressure on budgets to meet future demand. Lead Author, Professor Meg Morris, Head of School of Physiotherapy is aware of the problems and warns, "We will not return to the young populations that our ancestors knew."

The Smart Technologies for Older People report surveys the current literature on the use of smart technologies to support ageing across the globe adding a valuable resource to the policy debate. Smart technologies can support older people by promoting independence, quality of life and wellbeing. Smart technologies support delivery of a range of products and services over devices such as tablets, phones, computers, TVs, virtual reality "gaming" systems, and sensor networks. Additionally, smart technologies allow for the delivery of telemedicine services to older people, prolonging the period they can remain living at home.

The Cost of Inaction on the Social Determinants of Health

The cost of government inaction on the social determinants of health, leading to health inequalities for the most disadvantaged Australians of working age, is substantial. This was measured in terms not only of the number of people affected but also their overall well-being, their ability to participate in the workforce, their earnings from paid work, their reliance on Government income support and their use of health services. Substantial differences were found in the proportion of disadvantaged individuals satisfied with their lives, employment status, earnings from salary and wages, Government pensions and allowances, and use of health services between those in poor versus good health and those having versus not having a long-term health condition. Improving the health profile of Australians of working age in the most socio-economically disadvantaged groups therefore would lead to major social and economic gains with savings to both the Government and to individuals.  This report was prepared for Catholic Health Australia by the National Centre for Social and Economic Modelling. (APO 4/6/12)