Complementary Medicines and the TGA

The Therapeutic Goods Administration (TGA) is Australia's regulatory authority for therapeutic goods and carries out a range of assessment and monitoring activities to ensure therapeutic goods available in Australia are of an acceptable standard with the aim of ensuring that the Australian community has access, within a reasonable time, to therapeutic advances.

Complementary medicines (also known as 'traditional' or 'alternative' medicines) include vitamin, mineral, herbal, aromatherapy and homoeopathic products.  They may be either listed or registered, depending on their ingredients and the claims made. The TGA provides:

*Complementary medicine regulation basics
*General information about how complementary medicines are regulated in Australia
*Standards, guidelines & publications
*Standards, guidelines and publications about the regulation of complementary medicines
*Forms for complementary medicine sponsors
*Links to forms for sponsors of complementary medicines
*Regulatory decisions & notices
*Notices and advice for sponsors and manufacturers of complementary medicines

Child & Adolescent Trauma, Loss & Grief Network

The Australian Child & Adolescent Trauma, Loss & Grief Network aims to promote understanding of child and adolescent trauma, loss and grief. It offers key resources to help people involved with, or who have responsibility for, children and adolescents as well as those who are interested in the impact of psychological trauma, loss and other adversities as they affect young people. It also provides an online forum for communication and sharing of information among professionals and community workers; as well as people involved in research, policy, education and training and other interested members of the community. The website is funded by the Australian National University and the Federal Government.

New Dimensions in Telemedicine

In the latest issue of the Health Advocate there is an update of the University of Ballarat trial of high definition three dimensional telemedicine applications. The full project compromises four proof of concept projects to text and trial innovative CT hardware and software used for the tele-assessment, diagnosis and follow-up of patients located at a distance form the clinical specialists in oral health, oncology, psychiatry, wound management and aged care geriatric services.

Improving Transitions: How to Guides

The Institute for Healthcare Improvement has recently updated its four How-to Guides on improving transitions out of the hospital to:

Community Settings
Skilled Nursing Facilities
Home Health Care
Clinical Office Practice
From the IHI newsletter: “The How-to Guides are designed to support hospital-based teams and their community partners in co-designing and reliably implementing improved care processes to ensure that patients who have been discharged from the hospital have an ideal transition to the next setting of care. All guides focus on reducing avoidable rehospitalizations, and all are free to download.”

Simple walk test predicts heart events

Researchers have found that a 6-minute walk test can provide prognostic information at low cost in patients with stable coronary heart disease. The research, involving 556 patients with stable coronary heart disease (CHD) followed over 8 years, was published in the Archives of Internal Medicine.
Arch Intern Med. 2012;():1-7. (Published online June 12, 2012)

Australia’s Health 2012 in brief

'Australia's health 2012: in brief' presents highlights from the Australian Institute of Health and Welfare's thirteenth biennial report on the nation's health, which has just been released.

There are many positive things to say about the health of Australians. We generally have good health, our health is improving on many fronts, and we compare well with other countries. There has been a great deal of progress over the past century.  But there are negatives, which include growing obesity, the doubling of Diabetes since 1989, and rises in the incidence of mental illness, Chlamydia and kidney disease.  This short but informative report provides an overall picture of national birth, death and disease rates and provides suggestions for improving the health of the nation.  Overseas comparisons are drawn.

New independent pathology database

labtestsonline.org.au is a free, non-commercial website providing independent information about pathology testing. It attracts about 88,000 visits a month from the public, medical professionals and students.  Information is prepared by pathologists and scientists working in pathology laboratories and reviewed by an editorial board.

Topics include: pathology tests, diseases and clinical conditions, appropriate screening for disease, and specimen collection and processing, as well a general overview of pathology laboratories, the way they work and the people who work in them. 

The website has been developed by the Australasian Association of Clinical Biochemists (AACB) with support from the Royal College of Pathologists of Australasia (RCPA) to address a perceived paucity of trustworthy, impartial internet information on pathology suitable for a general audience. It has been funded under the Quality Use of Pathology Program of the Commonwealth Department of Health and Ageing.

An app is under development and due for release in the second half of 2012.

Choosing Wisely – decisions about which tests to perform

ABC Radio National’s Health Report this week included an interesting discussion about a project from the American Board of Internal Medicine and the ABIM Foundation called “Choosing Wisely”, where nine leading medical specialty societies in the US have identified specific tests or procedures that, according to them, are commonly used but not always necessary.  Dr Christine Cassel, President of the ABIM, said that in the US it was estimated that 30% of money spent on pathology and other tests could be saved by patients asking the right questions and doctors ordering the appropriate tests.  In addition, Cassel says that some of these unnecessary tests or procedures may actually be doing more harm than good.

Listen to, podcast or read the transcript of the interview here

Each of the nine specialty societies has provided a list of “Five things physicians and patients should question”.  Read more, including evidence, the lists and potential problems at the Choosing Wisely website.

AIHW transport accident reports

The Australian Institute of Health and Welfare has released new reports on transport accidents:

Trends in serious injury due to land transport accidents, Australia 2000-01 to 2008-09 presents estimates of trends in the number and rate of persons injured in Australia due to road vehicle traffic crashes. Serious injury is defined as when the person was admitted to hospital for their injury. Trends in high threat to life, or life threatening, injury are also reported. Over the 9-year period from 2000-01 to 2008-09, age-standardised rates for persons seriously injured due to a road traffic crash increased from 138.3 to 156.7 per 100,000 population, an average annual increase of 1.6%. Over one-quarter (26%) of those seriously injured due to road traffic crashes sustained life-threatening injuries over the 9-year period from 2000-01 to 2008-09. Over one-quarter (26%) of those seriously injured due to road traffic crashes sustained life-threatening injuries over the 9-year period from 2000–01 to 2008–09.

  

Serious injury due to land transport accidents involving a railway train, Australia 2004-05 to 2008-09 presents information on cases of serious injury resulting in hospitalisation due to transport accidents involving a train for the five year period 2004-05 to 2008-09. Over the 5-year period, 868 persons were seriously injured in Australia due to transport accidents involving a train, an average of 174 per year.  248 persons were seriously injured in Australia due to a level crossing accident, an average of 50 per year.

Mental Health Services in Australia website

The AIHW’s Mental Health Services in Australia website has been updated.

There are updates in the areas of mental health-related services in Australia in ED’s, community care, residential care, supported accommodation assistance and psychiatric disability support.  There are also updates on summary data tables and mental-health related indicators.

Future of community-centred health services in Australia

"The future of community-centred health services in Australia : an alternative view" has recently been published in Australian Health Review.  Community-centred health care works in conjunction with hospital-centred care and each has its strengths and weaknesses. The author of this article suggest that community-centred care has not been widely demonstrated to be a more cost efficient and cost-effective alternative to hospital-centred care for acute conditions.  He makes a plea for a reasoned and evidence-based approach to the distribution of health resources.
Cunningham, P. A. (2012). Australian Health Review, 36(2), 121-124. Please contact your library if you cannot access the full text.

Companion animals and health

"The 'pet effect' - Health related aspects of companion animal ownership" is an open-access article which discusses practical ways to integrate companion animals into health care and health promotion. The author summarises the health-related benefits of companion animal ownership and makes recommendations to GPs about how they can integrate discussions about pet interaction into everyday practice. Bringing up this subject could be a catalyst for engaging patients in discussions about preventive health, and could enable GPs to deliver more tailored patient management and personalised lifestyle recommendations.  

Smith, B. (2012). Australian Family Physician, 41(6), 439-442

Bullying in the Australian medical workforce

Bullying in the Australian medical workforce: cross-sectional data from an Australian e-Cohort study, published in Australian Health Review, aims to describe the prevalence of perceived workplace bullying in the Australian medical workforce, and investigate the relationship between workplace bullying and job satisfaction, health status, and current and planned medical workforce participation. 

The paper found that 25% of doctors participating in this study reported experiencing persistent behaviours in the last 12 months that had undermined their professional confidence or self-esteem. Victims of bullying had poorer mental health, had taken more sick leave in the last 12 months, were less satisfied with their current jobs and with being doctors, were more affected by job stressors and were more likely to be considering ceasing direct patient care than non-bullied doctors.
Australian Health Review 36(2) 197-204 http://dx.doi.org/10.1071/AH11048

Surgical Interventions to Treat Obesity in Children and Adolescents

HENews is an information service provided by the WHO Regional Office for Europe's Health Evidence Network. The first evidence report of the renewed HEN synthesis series "Do surgical interventions to treat obesity in children and adolescents have long- versus short-term advantages and are they cost-effective?" is now online.

Respiratory Failure on MedlinePlus

Respiratory Failure has recently been updated on the list of Topics on MedlinePlus.  Each Topic Review includes the links to the latest research, references, articles, trials, disease management and patient handouts.

Medline Plus is a service of the U.S. National Library of Medicine and the National Institutes of Health and the list of Topic Reviews includes 900 diseases, illnesses, health conditions and wellness issues.

NSW health and medical research strategic review 2012

This NSW Health Review assesses the current performance of health and medical research in NSW, makes recommendations on how the sector can be improved, better coordinated and leveraged; and proposes ways in which the NSW health needs, clinical trials and commercialisation capacity can be better supported or expanded. Health and medical research are critical activities of the NSW public health system that support the delivery of better treatments and technologies to improve patient care and better preventive efforts to improve the health of the community.
Download the review here.

The health of Australia's males

This AIHW report "The health of Australia's males: a focus on five population groups" examines the distinct health profiles of five male population groups, characterised by Aboriginal and Torres Strait Islander status, remoteness, socioeconomic disadvantage, region of birth, and age.

Anticoagulants the Leading Reported Drug Risk in 2011

QuarterWatch, published by the Institute of Safe Medication Practices (ISMP) in the United States, monitors domestic, serious adverse drug events reported to the FDA to “identify trends in drug safety, report signals for specific drugs, and to seek to improve the system”. The latest edition looks at the calendar year of 2011 where an estimated 2 to 4 million persons suffered serious, disabling, or fatal injury associated with prescription drug therapy, based on the analysis of  reports to the U.S. Food and Drug Administration. The most frequently identified suspect drugs in direct reports to the FDA were the anticoagulants dabigatran and warfarin, showing that inhibiting clotting ranks among the highest risk of all drug treatments.”

Latest in Healthcare Infection

The latest issue of Healthcare Infection has been published and includes:

• Surveillance of surgical site infections after open heart surgery (Rosanna Loss, Günter Marggraf, J. Adam Piotrowski, Jaroslaw Benedik, Birgit Ross, Dorothea Hansen, Heinz G. Jakob,Walter Popp )

• Surgical site infections following caesarean section at Royal Darwin Hospital, Northern Territory (Katie Henman, Claire L. Gordon, Tain Gardiner, Jane Thorn, Brian Spain, Jane Davies, Robert Baird )

• A new approach to improving hand hygiene practice in an inner city acute hospital in Australia (Giulietta Pontivivo, Ketty Rivas, Julie Gallard, Nickolas Yu, Lin Perry)

• Formative and process evaluation of a healthcare-associated infection surveillance program in residential aged care facilities, Grampians region, Victoria (Mary Smith, Ann L. Bull, David Dunt, Michael Richards, Badrika Suranganie Wijesundara, Noleen J. Bennett).

Staff in NSW Hospitals will have full text access, otherwise contact your Librarian.

Cognitive behavioural therapy for insomnia

Comparative effectiveness of cognitive behavioral therapy for insomnia : a systematic review is an open-access article in the latest issue of BMC Family Practice.  Insomnia is a common condition which may require long term treatment. Cognitive behavioural therapy for insomnia (CBT-I) is presented here as an alternative to medical treatment, with the authors finding evidence to suggest that CBT-I is effective and may be more durable than treatment with medication. Primary care providers are encouraged to consider CBT-I as a treatment option for patients with insomnia.

Mitchell, M. D., Gehrman, P., et al. (2012). BMC Family Practice, 13, 40.

Why older patients of lower clinical urgency choose to attend the Emergency Department

This Australian study in the Internal Medical Journal examined non-clinical factors associated with Emergency Department (ED) attendance by lower urgency community-dwelling older patients. The research addressed feelings of social connectedness, perceived accessibility to primary care and reasons for attending EDs. Results indicated that most of the patients who presented to EDs did so due to perceived access block to primary or specialist services, and an expectation of more timely and specialised care. Considerations for developing new models of care to meet the specific needs of this age group are discussed.

Please contact your library for the full text of this article if you do not have access.

Lowthian, J. A., Smith, C., et al. (2012). Internal Medicine Journal, doi: 10.1111/j.1445-5994.2012.02842.x.

Trends in the Australian Dental Labour Force, 2000 to 2009

This report presents findings from the 2009 national dental labour force data collection, which includes all dentists (general dental practitioners and specialists), dental hygienists, dental therapists, oral health therapists and dental prosthetists across Australia. There has been an overall increase in the number of dental professionals, with Dental therapists as the only group to decrease in number because of the move towards dual qualified oral health therapists.  There were around 3,800 allied dental practitioners in Australia in 2009. Almost all dental hygienists, dental therapists and oral health therapists were women, while nearly 90% of the 1,000 or more practising dental prosthetists were men.

Indigenous adolescent mental health

Indigenous adolescent mental health : what is the role of primary health care?  is a review by Caryn Butler from the PHC RIS Research Roundup series.  It summarises research on the state-of-play of Indigenous adolescent primary mental health care in Australia. The differences between Indigenous and non-Indigenous concepts of mental health are presented, with Indigenous Australians more likely to be hospitalised for mental health disorders than the general Australian population. Possible reasons for this disparity are explored and suggestions are made for improvements.

Mothers with a history of childhood sexual abuse - review

Cindy Tarczon from the Australian Institute of Family Studies has reviewed the literature examining the impacts of a history of maternal childhood sexual abuse on parenting capacities and the impacts on children.  Mothers with a history of childhood sexual abuse : key issues for child protection practice and policy examines the domains of mental health, intimate partner violence, substance abuse and homelessness and the overlap with a history of maternal childhood sexual abuse, highlighting the difficulties faced by these women when engaging with statutory and welfare agencies.

Survivors of childhood sexual abuse who become shared clients of child statutory agencies and allied health service providers are often difficult to engage in services due to issues of trust and safety.  The author suggests that by expanding our understanding of the indirect effects of childhood sexual abuse in areas such as mental health, intimate partner violence, substance abuse and homelessness, we can become more informed of the stressors that affect some women's parenting capacities and create service responses that enhance their own lives and the lives of their children.

Hospitalisations due to falls by older people, to 2009

Three new reports from the Australian Institute of Health and Welfare use hospital separations data from the National Hospital Morbidity Database to describe fall-related hospitalizations in the financial years 2006–07, 2007-08 and 2008-09.  Trends since 1999 are also presented. 

From the 2008-9 report, significantly more females suffered fall-related hospitalisations, mainly with hip and knee injuries.  Males presented with more head injuries.  One in every ten days spent in hospital by a person aged 65 and older in 2008–09 was directly attributable to an injurious fall. These episodes of hospital care used 1.2 million patient days over the year and the average total length of stay per fall injury case was estimated to be 15.8 days.