Review of Acute Rheumatic Fever and Rheumatic Heart Disease Among Indigenous Australians

This review , or as a pdf, of acute rheumatic fever and rheumatic heart disease among Indigenous Australians has been prepared by the Australian Indigenous HealthInfoNet as a part of our contributions to ‘closing the gap’ in health between Indigenous people and other Australians by making relevant, high quality knowledge and information easily accessible to policy makers, health service providers, program managers, clinicians, researchers and the general community. The main purpose of the review, which follows the model of narrative reviews/syntheses, is to provide an authoritative, up-to-date review of acute rheumatic fever and rheumatic heart disease among Indigenous people that: (1) is a valuable overview for people working in the area; and (2) assists in the development/refinement of policies, strategies and programs. (APO 10/10/13)

Overweight and Obesity Rates Across Australia, 2011-12

In 2011–12, 10.8 million adults were either overweight or obese, and of these 4.7 million were obese.
This report, from the National Health Performance Authority (NHPA), shows that the percentage of adults who were obese varied threefold across local areas, from 14% in Sydney North Shore and Beaches to 41% in Loddon-Mallee-Murray. In three-quarters or more of communities for which we have comparable data, one in four adults were obese in 2011–12. The percentage of adults who were overweight or obese increased with geographic remoteness and lower socioeconomic status. Yet still half of adults (54%) in the wealthiest urban areas were overweight or obese, and two in 10 (19%) were obese. Overweight and obesity rates are increasing rapidly across Australia. In 1989, 44% of adults were overweight or obese, rising to 63% in 2011–12. Health problems related to excess body weight impact the health care system, as well as individuals, families and the community. (APO 24/10/13)

Review of Ear Health and Hearing Among Indigenous Australians

This review of ear health and hearing among Indigenous Australians has been prepared by the Australian Indigenous HealthInfoNet as a part of our contributions to ‘closing the gap’ in health between Indigenous people and other Australians, or as a pdf. The aim is to make relevant, high quality knowledge and information easily accessible to policy makers, health service providers, program managers, clinicians, researchers and the general community. The main purpose of the review, which follows the model of narrative reviews/syntheses , is to provide an authoritative, up-to-date review of ear health and hearing of Indigenous people that (1) is a valuable overview for people working in the area; and (2) assists in the development/refinement of policies, strategies and programs.

Overcoming Governance and Cost Challenges for Australian Public Hospitals

Australia will face problems funding its public hospital and other publicly funded health services if cost increases continue at the current rate in the context of ever-increasing use and an ageing population. The challenges of sustainably financing the cost of health will be exacerbated by inefficiencies in the public hospital sector—unless productivity improvements reduce the quantity of public resources consumed by public hospitals. This report, Overcoming Governance and Cost Challenges for Australian Public Hospitals: the Foundation Trust alternative, identifies and discusses some of the major governance issues that impede public hospital performance and that can be revised within the existing Medicare framework via state government-initiated reforms, principally by adopting quasi market-based initiatives. It was written by Peter Phelan and Jeremy Sammut of the Centre for Independent Studies. (APO 13/10/13)

Tobacco Smoking Rates Across Australia, 2011–12

This report by the National Health Performance Authority (NHPA) presents adult smoking rates at the local level across Australia. In 2011–12, 2.8 million adults smoked tobacco daily and smoking rates varied across local areas. This report shows that the percentage of adults who smoked daily varied four-fold across local areas, ranging from 6% in Sydney North Shore and Beaches to 28% in Grampians. In four local areas, one in 10 adults or fewer were daily smokers. Rates in some local areas were still relatively high as one-third of all local areas had smoking rates of at least 20% – equivalent to at least one in five people smoking daily. Smoking is a major risk factor for many chronic conditions including coronary heart disease, stroke and many cancers. Rates of smoking have been declining for many decades. Latest national data shows 16% of adults smoked daily in 2011–12. Smoking is still one of the largest single preventable causes of death and disease in Australia and this represents an enormous social and economic burden on individuals and the health system. (APO 24/10/13)

The rising cost of musculoskeletal conditions in Australia

A new report from Arthritis and Osteoporosis Victoria, A problem worth solving: the rising cost of musculoskeletal conditions in Australia,  makes a case for why there needs to be a proactive, strategic response.  In 2012 the study found that there had been 6.1 million Australians affected (26.9% of the population), including 2.9 million people with back problems, 1.9 million people with osteoarthritis, 0.8 million people with osteoporosis and 0.5 million people with rheumatoid arthritis.

The cost to the Australian economy of these conditions in 2012 was estimated at $55.1 billion, including direct health costs, lost productivity and reduced quality of life.  A 43% growth in cases was projected over the next 20 years, especially in people over 75.

Depression in residential aged care 2008-2012

This AIHW report explores the prevalence and characteristics of people with symptoms of depression in residential aged care. In 2012, 52% of all permanent residential aged care residents had symptoms of depression, which resulted in higher care needs.  Changes to routine, loss of independence and physical relocation to a new environment are cited as some of the reasons for the onset of depressive symptoms.

How social status affects health

Robert Douglas, Emeritus Professor in Epidemiology and Population Health at the Australian National University, has written a piece for The Conversation, It's good to be king: how social status affects health.  He summarises the latest thinking on this topic, stating that this growing area of research supports the a social view of disease and treatment - that lower social standing leads to lower mental, social and physical wellbeing.  Several studies are linked concerning the complex health consequences of poverty and the importance of social inclusiveness.

New Closing the Gap Clearinghouse resource sheets

Two new resources have been published by the AIHW's Closing the Gap Clearinghouse.

Engagement with indigenous communities in key sectors examines approaches to engagement with Aboriginal and Torres Strait Islander communities and what is and is not working.  It concentrates on early childhood services, environmental and natural resource management activities as well as health programs.

Engaging with Indigenous Australia: exploring the conditions for effective relationships with Aboriginal and Torres Strait Islander communities provides an overview of evidence-based research on this topic, what is most effective and how engagement can be enhanced - especially in regional areas.

Elective surgery waiting times 2012-13

In 2012-13 about 673,000 patients were admitted to Australian public hospitals from elective surgery Australian Hospital Statistics 2012-13: elective surgery waiting times also gives a breakdown of types of surgery, with one in four patients undergoing general surgery and one in seven orthopaedic surgery. Compared to the previous year, admissions for elective surgery increased by 1.8% across Australia.

Health impact of bushfire smoke

A topical item in The Conversation this week, "What you can do about the health impact of bushfire smoke" has been written by epidemiologists Martine Dennekamp from Monash University and Fay Johnstone from the University of Tasmania.  The authors express particular concern about the very small PM2.5 particles of smoke that can penetrate deep into the lungs and have been shown to have an effect on the respiratory and cardiovascular systems.  People particularly at risk, such as the elderly, pregnant women and those with a history of lung or heart disease, are advised to stay indoors with doors and windows sealed if they are near a fire area and cannot relocate.  

Children and needles: a pain solution

With a son who had a phobia of needles, Dr. Amy Baxter stumbled upon a solution: a high-frequency vibrating ice pack that helps disrupt pain signals on their way to the brain. She stuck a cute bee on the front, won a $1 million federal health grant, and the product now known as Buzzy was born.
(re-posted from NPR Weekly Innovation Blog series)

Vital signs 2013: the state of safety and quality in Australian health care

The Australian Commission on Safety and Quality in Health Care has released VitalSigns 2013: The State of Safety and Quality in Australian Health Care. This report provides an overview of a series of key topics in relation to the safety and quality of Australia’s health care system.

Professor Debora Picone, Chief Executive of the Commission noted “Vital Signs 2013 focuses on three important questions that members of the public may ask about their health care. Will my care be safe? Will I get the right care? Will I be a partner in my care?”

Sunscreen helps protect key gene that fights skin cancer

Two out of three Australians will be diagnosed with some form skin cancer before turning 70. Australian researchers have completed a "world-first" study that provides yet another reason to always wear sunscreen. Researchers at the University of Technology Queensland say slip, slop, slap helps protect a key gene that fights all three forms of skin cancer. 
Lead researcher Dr Elke Hacker said that sunscreen helps in eliminating the risk of skin cancers like BCC (basal cell carcinoma), SCC (squamous cell carcinoma) and malignant melanoma. She also added that sunscreen safeguarded a superhero gene called p53 that helps prevent cancer.
"As soon as our skin becomes sun damaged, the p53 gene goes to work repairing that damage and thereby preventing skin cancer occurring" Dr Hacker said.  The study has been reported in the journal Pigment Cell & Melanoma Research.

It's all about the culture

From the Hospitals in Pursuit of Excellence (HPOE) is this new case study which describes how a US health care system, Mountain States Health Alliance (MHSA) in Virginia USA, adopted Lean management and found that the transformation meant improved patient care, employee satisfaction and reduced costs as MSHA shifted its organisational culture.
Andrew Wampler, assistant vice president on the whole of Tenessee operations made this comment: “When we first began looking into Lean, we saw it as a cost cutting tool. After visiting the hospital sites and seeing Lean in action, we quickly learned it is much more than cost cutting and flowcharts—it is a cultural transformation across the entire health care organization that enables workers on the front lines to develop strategies to streamline processes and decrease waste. As a result, the hospitals we visited not only improved the bottom line; they made impactful changes that improve the quality of care.”
To read more about this case study on improving organisational culture, click here.

No health without mental health: the link between chronic disease and mental illness

Many physical health conditions increase the risk of mental illness, while poor mental health is known to increase the risk of diseases such as heart disease, stroke and cancer.To address the issue of unacceptably poorer health outcomes of people with chronic disease and the associated mental illnesses, nurses and midwives need to have the knowledge and skills to identify manage and refer their patients.

As such, the Australian College of Mental Health Nurses has released a series of online resources aimed at improving the knowledge and skills of nurses to identify and manage mental health conditions associated with chronic disease.

These free online resources attract continuing professional development points and focus on four chronic disease areas: cancer, cardiovascular disease, diabetes and respiratory disease. You will need to register to access these free resources which will be made available October 22, 2013.

For further information, and to access these resources, go to www.acmhn.org/chronic-disease-elearning 

Chronic kidney disease: regional variation in Australia

This report on chronic kidney disease shows that people from remote and very remote areas were 2.2 times more likely to die from chronic kidney disease than people from major cities. People from very remote areas were at least 4 times more likely to start kidney replacement therapy (dialysis or kidney transplant) than people from non-remote areas.  

Chronic kidney disease is a common and serious problem in Australia and its management can be resource intensive, particularly for the most severe form of the disease: end-stage kidney disease. 
Download this AIHW report here.

An Introduction to social media for scientists

This open access article describes the exploding popularity and rapid expansion of online tools and the increasing number of science-based professionals taking advantage of them. Many researchers still feel overwhelmed and hesitant toward getting started with social media and the aim of this paper is to familiarise researchers with existing internet resources by discussing: prospective benefits that can stem from online science conversations; explaining how scientists can efficiently and effectively harness online resources; and providing an overview of popular online tools. Access the article in full here.

Bik HM, Goldstein MC (2013) An Introduction to Social Media for Scientists. PLoS Biol 11(4): e1001535. doi:10.1371/journal.pbio.1001535

Projection of the number of young people in residential aged care

The National Disability Insurance Scheme was launched in July 2013 and this report from the Summer Foundation provides an estimate of the unmet needs and resources required for housing and support in the three designated NDIS launch sites over the next three years.

National Disability Insurance Scheme launch sites: projection of the number of young people in Residential Aged Care indicates that at present there are 6192 people under the age of 65 in residential aged care, and 592 under the age of 50. This is not desirable and the problem needs to be addressed by the provision of affordable and appropriate housing.

Making Health Care Safer

Making Health Care Safer II: An Updated Critical Analysisof the Evidence for Patient Safety Practices (AHRQ Evidence Report No. 211) updates the 2001 report from the US Agency for Healthcare Research and Quality. It analyses a growing body of patient safety research using an evidence-based approach. 

After analyzing 41 patient safety practices, an international panel of patient safety experts identified 22 strategies that are ready for adoption.  Ten of these practices are "strongly encouraged" for adoption based on the strength and quality of evidence.

  

Movement between hospital and residential aged care 2008-09

This report from the Australian Institute of Health and Welfare examines movements between hospital and residential aged care by people aged 65 and over in 2008-09. Overall, almost 10% of 1.1 million hospitalisations for older people were for people already living in residential aged care. A further 3% of hospitalisations for older people ended with the patient being newly admitted into residential care. The report also describes the characteristics of people moving between the two sectors, and short-term outcomes for people going into residential care.

COPD best practice

The latest edition of the Australian Health Review includes an article by Teresa Burgess et al, Best-practice care for people with advanced chronic obstructive pulmonary disease: the potential role of a chronic obstructive pulmonary disease care co-ordinator.  This qualitative study found that people with this condition often have trouble navigating the many different services they may require, and that the lack of communication between these services can also be a problem.  A dedicated care coordinator with advanced nursing skills could ensure that people with COPD have streamlined care which is appropriate and accessible.

Australian Health Review 34 (4) 2013 : 474-81.  Available though CIAP or contact your health librarian.

A Review of Sexual Health Services for Gay, Bisexual and Other Men who have sex with men in Western Australia: survey report July 2013

The aim of this review was to describe the characteristics of men who have sex with men (MSM) accessing both hospital and community-based sexual health services in the Perth metropolitan area and assess the acceptability of these services to the MSM who access them. The majority of new HIV diagnoses in Australia are in gay, bisexual, and other (MSM). Providing accessible, appropriate and acceptable sexual health services is essential as a significant proportion of MSM are not testing for HIV and sexually transmitted infections (STIs) at the recommended frequency (at least once per year for sexually active MSM, and more often for higher risk men). Recognised barriers to testing include not having enough time to test and difficulty getting an appointment.

In July 2010, a new community-based clinical service employing peer workers targeting gay and bisexual men opened in West Perth. M Clinic, managed by the Western Australian AIDS Council (WAAC), complements traditional hospital-based sexual health services already operating in Perth and Fremantle. Until this project, no external evaluation of acceptability among MSM clients involving all of these services had been undertaken. The report was authored by Damian Conway, Martin Holt, Michael Atkinson, Lewis Marshall, Jenny McCloskey, Patricia Langdon, Denton Callander and Rebecca Guy of the Kirby Institute. (APO 30/7/13)

A Unified Approach for the Evaluation of Telehealth Implementations in Australia

This paper provides a conceptual framework for the evaluation of telehealth implementations in Australia, and also provides an evidence base that illustrates the current state of telehealth evaluation on an international scale. It was produced as part of a one year study, funded by the University of Melbourne interdisciplinary seed grant. This paper will firstly provide a conceptual framework that incorporates the key dimensions, criteria and measures that need to be considered in the evaluation of telehealth implementations in Australia.

The paper is divided into three sections. Section 1 provides an overview of the literature, method and proposed framework. Section 2 provides the proposed framework for telehealth evaluation. Section 3 describes the results of grouping the various criteria and measures mentioned in the literature. This paper also has two Appendices. Appendix A should be used to support the reading of Section 3. Appendix B provides an annotated bibliography of the papers reviewed, as well as further information on the literature.

Chronic Disease Management: the Role of Private Health Insurance

This research paper, by Amanda Biggs of the Parliamentary Library, provides background information on private health insurance arrangements, as well as the challenges emerging from increasing rates of chronic disease, and discusses the role of Broader Health Cover.

By way of introduction, in 2007, a series of major reforms to private health insurance (PHI) were introduced with the passage of the Private Health Insurance Act 2007(PHIA). One of the key reforms, in fact ‘the most significant new measure’ according to the then Health Minister Tony Abbott, was Broader Health Cover (BHC). BHC allows health insurers to offer benefits to members for programs that either prevent or substitute for hospitalisation, or that help patients with a chronic disease better manage and reduce the effects of that disease.  In effect, these reforms were intended to give health insurers a more significant role in keeping their members healthy.

This paper aims to fill some gaps in knowledge about the implementation of BHC, in order to contribute towards a better understanding of the role such programs can play, and to promote further debate and investigation. Because health insurance is subsidised by the Australian taxpayer via the private health insurance rebate, there is also a public interest in a better understanding of the impact of these programs.

National Mental Health Survey of Doctors and Medical Students

This report by Beyond Blue finds that doctors reported substantially higher rates of psychological distress and attempted suicide compared to both the Australian population and other Australian professionals.

The key objectives of this survey were to:

• better understand the issues associated with the mental health of Australian medical students and doctors.
• increase awareness across the medical profession and broader community of issues associated with the mental health of medical students and doctors.
• inform the development of mental health services, programs and support for medical students and doctors to address the prevalence of depression and anxiety.  (APO 8/10/13)