Two Hearts One Future

 This report "Two hearts one future: a report of patients' & carers' experiences in surviving and coping with a first heart attack" finds that many heart attack survivors underestimate their risk of having a future heart attack. Preventative Health at the Baker IDI Heart and Diabetes Institute, under the auspices of the NHMRC Centre of Research Excellence to Reduce Inequality in Heart Disease, undertook a national survey to explore the experiences of individuals who survived their first heart attack (“subjects”). It also explored equivalent experiences in those caring (“carers”) for such individuals (but not necessarily the same ones who responded to the survey). Overall, these data provide a framework for improving our collective understanding of the causes and consequences of heart attack; particularly from the combined patient and carer respective. We found numerous misperceptions around heart attacks in those one might suspect would “know better”. We therefore need to improve education and support programs. Principal investigator was Professor Simon Stewart, with the Research team: Dr Yih Kai Chan, Dr Melinda Carrington and Ms Alicia Calderone. (APO 29 July 2013)

National Definitions for Elective Surgery Urgency Categories

A new report, National definitions for elective surgery urgency categories: proposal for the Standing Council on Health  was released today, 31st July, 2013, by the Australian Institute of Health and Welfare. In 2012, the Australian Institute of Health and Welfare and the Royal Australasian College of Surgeons worked together to develop national definitions for elective surgery urgency categories, at the request of the Standing Council on Health. The development of the national definitions resulted in a package of six integrated components proposed for adoption. This report presents the proposed definitions and components.

2013-14 Budget: Analysis of Health and Ageing Provisions

 In a tough political and budget year with several major initiatives to be funded - most notably the Gonski education reforms and the National Disability Insurance Scheme, now known as DisabilityCare Australia - the health and ageing section of the 2013-14 Budget has fared reasonably well. Overall the Budget contained $43 billion in savings over the forward estimates, much of which will be funneled into these new ‘critical investments.’ Of this, $1.22 billion over five years was taken from current health programs, with the majority of this ($902 million) from Medicare. This analysis was prepared by Lesley Russell at the Menzies Centre for Health Policy.  (APO 26 June 2013)

The Longitudinal Study of Australian Children: Annual Statistical Report 2012

This report, Growing up in Australia: the Longitudinal Study of Australian Children (LSAC), aims to provide the evidence base for future research and policy development to support family functioning and children's health and wellbeing. LSAC was initiated and is funded by the Australian Government Department of Families, Housing, Community Services and Indigenous Affairs, and is conducted in partnership with the Australian Institute of Family Studies (AIFS) and the Australian Bureau of Statistics (ABS). A consortium of leading researchers and experts from universities and research agencies provide advice to the study.
This is the third volume in the LSAC Annual Statistical Report series, which for the first time incorporates data from the fourth wave of the study. The purpose of these reports is to provide an overview of the data from the study and to address policy-relevant questions about aspects of Australian children’s lives and development. The reports make use of the longitudinal nature of LSAC data to describe continuities and change as children develop, as well as the dynamics of change in their families, neighbourhoods and communities. (APO 19 June 2013)

Emergency Services and Mental Illness

What do people affected by a mental illness and carers say about the help they receive from emergency services? What is needed to improve the response of police and ambulance services, mental health crisis teams, and hospital emergency departments when someone has a mental health crisis?
A survey was conducted between November 2012 and January 2013, using a convenience sample of 606 responses to an anonymous questionnaire accessed via www.sane.org (SANE Australia). Most respondents were female (77%) and aged predominantly 25-49 (36%). The diagnoses reported most frequently were depression (27%), bipolar disorder (18%), schizophrenia (15%), anxiety disorders (11%), and personality disorders (7%). The survey was intended to investigate the experience of respondents when they had used emergency services for an urgent mental health concern. Results have been used to identify barriers to effective care, and to make recommendations for improvements. This two-page article summarises the results. (APO 28 June 2013)

Health Provider Broadband Connectivity: a Review of Technical Requirements

Over the next 5 to 10 years high-speed broadband will enable a number of new services in the health sector including telemedicine consultations, electronic health records, eLearning for clinicians, and personalised medicine and participatory healthcare. Currently, there are a variety of piecemeal data connectivity arrangements with multiple connections and service providers in the health sector. For the healthcare sector to take advantage of high-speed broadband, delivering an efficient and effective transformation of service delivery and supply chain reform, integrated planning and better coordination of data connectivity are essential.

At present there is little information exchange and knowledge sharing across the health sector. This project, by Kathleen Gray and others at the Institute for a Broadband-Enabled Society, addresses this gap in knowledge and will develop a systematic and strategic map of health provider connectivity pathways. The research team will review scientific, technical and policy literature to analyse data connectivity requirements in health care environments producing a white paper that will inform debate within the sector. In addition to the literature review, empirical research will explore the typical current arrangements and future requirements among major Victorian health provider organisations. Finally, this project will develop service delivery models to support the financing, management and governance of data connectivity. (APO 3 July 2013)

Impact of technologies on young men's mental health

The Young and Well Cooperative Research Centre has published its first national survey, Game on: exploring the impact of technologies on young men's mental health and wellbeing.  Some troubling results from the survey of 14 young men aged 16-25 indicate the failure of our mental health system to address the needs of this group:

• Nearly one in five felt that life is hardly worth living
• Nearly one in ten had thought about taking their own life
• 42% had experienced psychological distress

The report suggests that using technologies which match current online behaviour could offer hope for improving the wellbeing of this group.  The young men who reported moderate to very high levels of psychological distress were more likely to talk about problems on the Internet, or to use the Internet to find information about their issues.

Use of seclusion during admitted patient care

This is the first time national seclusion information has been made available in Australia, and it shows that seclusion rates are falling. Seclusion is defined as confinement at any time of the day or night alone in a room or area from which free exit is prevented.
Reducing the use of seclusion is a national priority for mental health, and was formally endorsed by health ministers in the National safety priorities in mental health: a national plan for reducing harm. Information on seclusion in public mental health facilities has been made available on the Australian Institute of Health and Welfare's (AIHW) Mental Health Services in Australia website.

Changing how psychotropic medicines are used in residential aged care.

RedUSe is a new program aimed at reducing use of sedatives in aged care. It is led by Dr Juanita Westbury from the University of Tasmania (UTAS) and is based on extensive research she conducted with colleagues at the UTAS School of Pharmacy on the impact psychotropic medicines have on aged care residents.

The major aim of the program is to educate aged care professionals and promote awareness of drug mismanagement and chemical restraint of the elderly.

With nearly 60% of aged care residents prescribed psychotropic drugs and the percentage increasing, it has become a priority to address the over use of sedatives in our ever increasing number of dementia sufferers.

For more information or to register your interest in the RedUSe program contact Dr Juanita Westbury, RedUSe Program Lead at Juanita.Westbury@utas.edu.au

The Doctor’s Instagram

Figure 1 is being called the Instagram for doctors and is a free, safe way of sharing photos for healthcare proffessionals. The app is a collection of medical images submitted by doctors to share, collaborate and learn from.  Doctors are verified using their institutional email address as the app takes patient privacy very seriously.  It has a face detection program that automatically blocks out the face in a submitted photo and it includes other editing tools to remove other identifying features.  A HIPPA authorization digital consent form is also included.  Patients click the agree button then sign screen/form. There are still some issues with searching, but for an app to be this popular inside 3 months of launching in May 2013, it is doing something right.

Co-founder Dr Joshua Landry says; "I developed Figure 1 because I wanted a safe way to share medical images with the medical community, while protecting patients’ privacy."

Search tool provides easy access to Aboriginal and Torres Strait Islander health literature

The Lowitja Institute launched a new search tool called LIt. Search. This tool makes online searching for information about Aboriginal and Torres Strait Islander health easy. LIt.search enables users to search the worldwide PubMed database and confine their search to articles about Aboriginal and Torres Strait Islander health. With one click, the tool provides access to all available literature in this field and to 27 predefined search topics. Searches can be refined further by adding keywords.

More on the prevention and incidence of stroke

Protecting your brain and prevention and treatment of stroke is the title of a recent ABC Radio National Health Report.  A US study has shown clearly how every minute counts when treating ischemic stroke.  Jeffrey Saver from the University of California led the study of over 58,000 patients and was interviewed about his findings. "We demonstrated for the first time that haemorrhage is increased the longer you delay the start of the therapy. And we also confirmed definitively that death from stroke is reduced if you start the therapy sooner."  

In the same Health Report, Ann Hunt from the AIHW was interviewed.  Recently the AIHW released its report, Stroke and its management in Australia: an update.  Hunt relayed the good news that the stroke event rate in Australia fell by 25% between 1997 and 2009, but that the estimated number of strokes increased by 6%. The increase in numbers was attributed to the ageing population. 

Saver JL, Fonarow GC, Smith EE, et al. Time to treatment with intravenous tissue plasminogen activator and outcome from acute ischemic stroke. JAMA. 2013;309:2480-2488. Abstract

New Body Shape Indicates Diabetes Risk

A novel trunk-to-leg-volume ratio shows a strong association with diabetes, high triglycerides, low high-density lipoprotein cholesterol, high blood pressure, metabolic syndrome, and mortality, according to data derived from whole body dual-energy X-ray absorptiometry scans of a representative sample of the US population. The authors believe this independent marker stratifies diabetes and mortality more accurately than currently available measures of body mass index (BMI) and waist circumference, and that those with this body shape may have elevated mortality even if they are not considered overweight.

The research article Ratio of Trunk to Leg Volume as a New Body Shape Metric for Diabetes and Mortality is available is available free full text at PLoS One.

Operating theatre efficiency report

In 2011-12, approximately 210,000 patients had elective surgery in over 270 public hospital operating theatres in New South Wales. The cost of elective surgery within hospitals is estimated to be $1.3 billion each year or about 17 per cent of NSW Health’s inpatient hospital services budget.  Managing operating theatre efficiency for elective surgery is a report from the NSW Auditor General released this month which gives all such statistics, as well as the fact that 45% of all admissions to operating theatres are for elective surgery. 

The report concludes that there is room for operating theatres to be managed more efficiently and that there is potential for more elective surgery at current funding and resourcing levels.  It was acknowledged that  despite elective surgery numbers growing by 6% over the last three years, public hospitals are now treating patients from waiting lists substantially within national clinical timeframes.  However, the audit showed that NSW Health is not meeting its three key elective surgery efficiency targets: theatre utilisation, cancellations on the day of surgery and first case starting on time.  One problem identified was that local management needs access to more information, particularly financial information, in order to manage operating theatres more efficiently.  Various other recommendations were made.

Stigma and discrimination against people with mental illness

A new study from mental health charity, SANE Australia, reports that stigma and discrimination against people with mental illness is widespread, harmful to recovery, and is a major barrier to participation in society for those affected.

The new report – A Life without Stigma – concludes that a national strategy to tackle stigma and discrimination associated with mental illness is vital, and should be a non-negotiable component of mental health policies and plans.

There’s something you can do to reduce your risk of stroke

Reposted from "The Conversation". Michelle McDonald, a Lecturer in rehabilitation at University of South Australia has written; "Many people who have had a stroke believe that their family history is the main reason for it, regardless of how well they look after themselves. While a family history of cardiovascular disease does increase your risk of stroke or heart attack, it doesn’t make it your destiny.

Exercising to the point of breaking a sweat plays a key role in stroke prevention, and can help change your family’s medical history. Read the rest of her interesting comments on a study recently released in the journal Stroke at "The Conversation" website.

National Bowel Cancer Screening Program report 2011-12

The National Bowel Cancer Screening Program : July 2011-June 2012 monitoring report has been released by the AIHW.  It presents statistics on the National Bowel Cancer Screening Program for Australians invited to take part during this period, when over 320,000 people were screened, with about 22,500 found to require further assessment. One out of every 15 assessments recorded detected an advanced adenoma (pre-cancerous lesion), and a bowel cancer was detected in 1 out of every 32 assessments.  

The National Bowel Cancer Screening Program (NBCSP) aims to reduce the incidence, illness and mortality related to bowel cancer in Australia by screening to detect cancers and pre-cancerous lesions in their early stages.  As in previous years, women were more likely to screen than men, but men had higher rates of screen-detected bowel cancers and overall incidence and mortality.  Aboriginal and Torres Strait Islander participants, those who lived in regional and remote regions and in areas of lower socioeconomic status, had higher rates of positive screening, yet lower rates of follow-up colonoscopies than other participants. 

Staying healthy - preventing infectious diseases in early childhood education and care

The 5th edition of Staying Healthy : Preventing infectious diseases in early childhood education and care services by the National Health and Medical Research Council (NHMRC) represents an increased focus on a risk-management approach to infection prevention and control principles in daily care activities. Staying Healthy provides educators and other staff working in education and care services with simple and effective methods for minimising the spread of disease. It contains advice on procedures and discussing exclusion periods with parents in six parts: 

• concepts of infection control 
• monitoring illness in children 
• procedures 
• issues for employers, educators and other staff 
• fact sheets on diseases common to education and care services 
• forms, useful contacts and websites. 

Australian indigenous kidney disease review

A new comprehensive review of Australian Indigenous kidney disease is now available on the HealthInfoNet Australian Indigenous web resource.  Review of kidney disease among Indigenous people by S. Stumpers and N. Thompson aims is to provide an overview of the burden of kidney disease among Indigenous Australians, since the prevalence of chronic kidney disease (CKD) and the overall levels of end-stage kidney disease (ESKD) among Aboriginal and Torres Strait Islander peoples are consistently reported as significantly higher than among other Australians.

The review looks at the context of kidney disease among the general Australian population, and the factors contributing to kidney disease among Indigenous people. Statistics are provided on incidence, prevalence and associated hospitalisation and mortality. The management and treatment of kidney health problems are discussed, and the current policies and strategies employed to address kidney health in Australia are outlined.

Model for palliative and end of life care service provision

The NSW Agency for Clinical Innovation has published their Framework for the Statewide Model for Palliative and End of Life Care Service Provision. This is the first step in developing a statewide model for palliative and end of life care and describes some of the complexities faced in providing quality palliative and end of life care across a range of acute, sub-acute, primary care and community settings, including the home.

The Framework also sets the groundwork for the development of a Model of Care by identifying the principles, service definitions and structural arrangements that are required for the delivery of effective, accessible and efficient care to people in NSW who are approaching or reaching the end of life, their families and carers.

Intimate partner violence - WHO guidelines

A health-care provider is likely to be the first professional contact for survivors of intimate partner violence or sexual assault and the World Health Organisation has issued a guidelines document to aid health professionals with their response.  Responding to intimate partner violence and sexual violence against women : WHO clinical and policy guidelines provides evidence-based guidance and advice for policy makers, encouraging better coordination and funding of services, and greater attention to training programs for health care providers. 
The guidelines are based on systematic reviews of the evidence, and includes:

• Identification and clinical care for intimate partner violence 
• Clinical care for sexual assault 
• Training relating to intimate partner violence and sexual assault against women  

The guidelines provide standards that can form the basis for national guidelines, and for integrating these issues into health-care provider education.

Emergency Services and Mental Illness

New research by SANE Australia has found that mental health services too often leave police, ambulance staff and families to pick up the pieces when people become unwell, revealing a crisis-driven system. More than 600 people completed the online survey, with almost three-quarters (72%) saying that risk of suicide or self-harm was the main reason for the emergency call.

64% of respondents said emergency services showed little awareness of the impact on family and friends and an even higher proportion (73%) reported that they had not been provided with any referral to services to support them. (Reposted from SANE Mental Health Sector Bulletin for June 2013)

Download SANE Research Bulletin 17: Emergency services and mental illness (June 2013)

Heart Health Information Sheets for Indigenous People

The Heart Foundation has developed information sheets to educate patients and communities about cardiovascular disease and its risk factors. Designed for patients and families, these information sheets are easy-to-read and cover a range of topics including:

• Blood pressure
• Cholesterol
• Coronary heart disease
• Heart attack
• Nutrition
• Obesity
• Physical activity
• Smoking  

Model Shows Large Impact of Flu Shots on US Disease Burden

Vaccination against influenza has a substantial annual impact on the burden of disease in the US, according to the results of a unique model developed by the Centers for Disease Control and Prevention. The vaccination program prevents influenza-related illnesses and hospitalizations on a very large scale, it estimates, avoiding about 40,000 hospitalizations in 2010-2011. The higher the coverage, the fewer the influenza cases, patient visits, and hospitalizations.
Influenza Illness and Hospitalizations Averted by Influenza Vaccination in the United States, 2005-2011  PLoS One | Jun 19, 2013 (FREE FULL TEXT)

Energy drinks: an unaddressed health hazard

Michelle Hughes, writing for the Crikey Health Blog, has addressed the issue of energy drinks. Dr Melissa Stoneham, Deputy Director of the Public Health Advocacy Institute WA has spoken out saying experts can tell you that energy drinks contain high levels of caffeine, sugar and novel ingredients, and are a public health hazard for young people. However sports people may tell you something different as they are often sponsored by the Energy Drink Companies.

Stroke and its management in Australia: an update

This report presents a comprehensive picture about, and the latest data on, stroke and how it is managed in Australia. It examines the impact of stroke on patients, their carers, the health system and aged care services. In particular for stroke patients, the report includes information on incidence, prevalence, hospitalisation, disability, treatment and deaths. The report also examines trends and inequalities in stroke and its management in Australia; and makes international comparisons; and identifies data gaps.

Download the full report here.

Programs to Improve Interpersonal Safety in Indigenous Communities

A new report from AIHW titled Programs to improve interpersonal safety in Indigenous communities: evidence and issues has been released this week. This Issues paper provides an overview of the range of programs and interventions that have been implemented in an attempt to improve aspects of community safety. It examines the outcomes of these programs delivered to indigenous Australians.

Download the full report for free online.