Nursing and Midwifery Workforce 2012

This report ,release by the Australian Institute of Health and Welfare on 29 November 2013, outlines the workforce characteristics of nurses and midwives in 2012. Between 2008 and 2012, the number of nurses and midwives employed in nursing or midwifery increased by 7.5%, from 269,909 to 290,144. During this period, nursing and midwifery supply increased by 0.5%, from 1,117.8 to 1,123.6 full-time equivalent nurses and midwives per 100,000 population. In 2012, the proportion of employed nurses and midwives aged 50 or older was 39.1%, an increase from 35.1% in 2008.

Impact of a Population-based HPV Vaccination Program on Cervical Abnormalities: a Data Linkage Study

Evidence that the human papillomavirus (HPV) vaccination program is preventing cervical pre-cancer lesions in young women has been published for the first time as part of a collaborative study between the Australian Institute of Health and Welfare (AIHW) and the Victorian Cytology Service (VCS). The findings, in an article written by Dorota M. Gertig et al and published in the medical journal BMC Medicine, are the first in the world to show that a population-based HPV vaccination program has resulted in a fall in cervical abnormalities within five years of implementation. (AIHW 27 November 2013)

Mental Health Services in Australia Website

The Australian Institute of Health and Welfare (AIHW) has released updated material on the: Mental health services in Australia website. The AIHW made national seclusion information (2008-09 to 2011-12) available for the first time in July 2013. This information extends the period of available data to 2012–13 and can be found in the ‘Admitted patient mental health-related care’ section under ‘Use of restrictive practices during admitted patient care’.  

The release of seclusion information by the AIHW will coincide with their public release at the 9th National Seclusion and Restraint Reduction Forum being held in Canberra on 28th November 2013. (AIHW 28 November 2013)

No Longer Just an Inner City Issue: Meeting the Demand for Needles, Syringes and Opioid Replacement Therapies (ORTs) Across Melbourne's Western Suburbs

Sufficient access to needles, syringes and opioid replacement therapies (ORTs) across the western suburbs of Melbourne, Victoria, is an important health issue for the people who require these services, the organisations that support their health and welfare and the communities they live in. This document, prepared by HealthWest Partnership, outlines current issues with access to these services in the western metropolitan region and makes recommendations for action. (APO 6 August 2013)

Gambling Problems Amongst the CALD Population of Australia: Hidden, Visible or Not a Problem?

There have been mixed research results when studying gambling problems in Culturally and Linguistically Diverse (CALD) communities in Australia and internationally. This study, published in the Asian Journal of Gambling Issues and Public Health, tests the feasibility of using nationally representative General Social Surveys for examining trends and patterns in gambling problems and other life stressors amongst the Australian CALD population. Two surveys were analysed to determine whether the CALD population experienced gambling problems and other life stressors at different levels to the non-CALD population, and to identify, using multivariable models, whether CALD related variables showed evidence of an association with reported gambling problems after adjustment for other covariates. There was no evidence that 2002 estimates of gambling problems were different in CALD and non-CALD populations. In 2006, there was evidence that gambling problems were lower in the CALD population compared with the non-CALD population (1.3% cf. 3.5%). In 2002 multivariable models there was no evidence of an association between CALD status or related variables with gambling problems, after adjustment for other variables. In 2006 multivariable models, there was evidence of an association between being the CALD population (protective), and being born in Oceania or New Zealand (risk) with gambling problems, after adjustment for other variables. The authors of this article are Matthew Stevens and Kate Golebiowska. (APO 20 Feb 2013)

Chronic Obstructive Pulmonary Disease (COPD) snapshot

Chronic obstructive pulmonary disease (COPD) limits airflow in the lungs. It includes emphysema and chronic bronchitis. This is a snapshot of the latest statistics on COPD in Australia, updated November 2013 by the Australian Institute of Health and Welfare (AIHW). It includes a link to information re: Death rate from COPD; Hospitalisation for COPD; Money spent on COPD in 2008-9.

National Performance Indicators to Support Neonatal Hearing Screening in Australia

Around half the children born with hearing impairment have no identified risk factor for the condition. It is widely acknowledged that delays in the identification and treatment of permanent childhood hearing impairment may profoundly affect quality of life in terms of language acquisition, social and emotional development, and education and employment prospects. All states and territories in Australia have universal neonatal hearing screening. This working paper, by the Australian Institute of Health and Welfare (AIHW), presents a set of performance indicators for monitoring neonatal hearing screening activity in Australia at a national level. National evaluation and monitoring provides a measure of how well neonatal hearing screening is achieving its aims and objectives and will enable strengthening of screening practices and administrative processes to further improve outcomes for Australian infants. (Report released by the AIHW on 25th November 2013)

Promoting Aboriginal Health Through the Arts: Overview of Supported Projects

This paper provides an overview of organisations and arts projects VicHealth supports and explores the role of arts in Aboriginal culture and the associated positive health impacts. Engagement with the arts can have powerful impacts on health, wellbeing and the strengthening of communities. For more than two decades VicHealth has been supporting the arts because of the great health promotion opportunities it provides. We know that access to the arts helps people connect socially and participate in their community’s cultural life. The role of the arts in exploring and communicating social concerns, giving voice to hidden issues and allowing self-expression is also a major contributor to health. (APO 19 September 2013)

NDIS Launch Sites: Projection of the Number of Young People in Residential Aged Care

The launch of the National Disability Insurance Scheme (NDIS) on 1 July 2013, heralded the start of a new era for people with disability in Australia. PricewaterhouseCoopers and the Summer Foundation have been collaborating to undertake a projection of people aged under 65 living in aged care nursing homes in the three NDIS launch sites that are targeting people in this group: Australian Capital Territory, the Hunter region of New South Wales and the Barwon region of Victoria. The Report estimates that although the NDIS will have been operational in the NDIS launch sites for three years, there will be an additional 40 young people living in nursing homes in these launch sites by June 2016. The report provides an estimate of the unmet needs and resources required for housing and support in the NDIS launch sites. (APO 2 October 2013)

Growing Older, Staying Well: Mental Health Care for Older Australians

This study, conducted by SANE Australia, finds that more support, services and education are needed to appropriately care for Australia's ageing population.
Recommendations:

• Stronger lobbying and advocacy giving the needs of older people living with mental illness more prominence in aged care and mental health
• Address social isolation in older adults living with mental illness as a central tenet of any policy reform and advocacy work in this area
• Consult with older adults when seeking to understand the experience of living with mental illness
• Mandatory mental health training for staff working in the aged care and community support sectors
• Provide clear and easily-accessible information for older adults, their families, friends and staff about mental illness in older age
• Encourage GPs and other primary health professionals to seek additional training and education in the treatment of coexisting physical and mental health problems      (APO 12 November 2013)

Monitoring Activities of the National Cervical Screening Program Safety Monitoring Committee

This report looks at the evidence collected and assessed by the Safety Monitoring Committee established to assess whether there were adverse outcomes following the introduction of new NHMRC guidelines on how women with a low-grade Pap test result or a treated high-grade cervical biopsy result should be managed. Acknowledging that new evidence may come to light in future which could affect this picture, the overarching message from the evidence currently available and the methods used to assess this evidence is that the new guidelines have not led to an increase in cervical cancer in the seven years since they were introduced. (Released by the Australian Institute of Health and Welfare (AIHW) 22 November 2013)

Cancer in Victoria: Statistics and Trends 2012

This report, edited by Vicky Thursfield, Carolyn Staines, Graham Giles, and Helen Farrugia for the Cancer Council Victoria, is a compilation of the latest available Victorian cancer statistics. The report covers the following key areas: Incidence, Mortality, Most common cancers, Less common cancers, Aboriginal and/or Torres Strait Islander Victorians, Trends in cervix cancer, Survival, and Projections. (APO 11 October 2013)

Clinical ICT Systems in the Victorian Public Health Sector

This audit report, by the Victorian Auditor-General's Office, examined the clinical information and communications technology (ICT) systems of eight public health services in Victoria to see whether they were appropriately planned and implemented and whether expected outcomes and benefits are being realised. It examined the HealthSMART clinical ICT systems implemented at four health services and clinical ICT systems implemented at four other health services. The Department of Health (DH) failed to complete the expected implementation of clinical ICT systems across 19 Victorian health services due to poor planning and an inadequate understanding of system requirements. It significantly underestimated project scope, costs and time lines, as well as the required clinical workflow redesign and change management efforts. In contrast, non-HealthSMART sites have used their own internally generated funds and implemented clinical ICT systems at a fraction of the cost of implementing HealthSMART. This audit found evidence of a number of potential clinical risks at three of the HealthSMART sites. In the absence of appropriate controls and effective mitigations, these issues could pose serious patient safety risks. (APO 31 October 2013)

Managing Madness: Mental Health and Complexity in Public Policy

This paper, by Sebastian Rosenberg and Ian Hickle, explores the concept of collaborative care, particularly in relation to a range of new models of organisation and service that are emerging in response to one of the most problematic areas of public policy – mental health. These emerging models of coordinated mental health care are testing the limits of the evidence supporting coordinated care, and require critical evaluation. Myriad concepts of collaborative or coordinated care in health, including mental health, have created multiple definitions. Once definitional issues have been surmounted, however, the evidence for coordination of health care is reasonably strong. There is considerable research about which treatments and programs are best for people with a mental illness. There are few areas seemingly as complex as mental health, given that responsibility for policy and service lies across all three tiers of Australian government and across multiple jurisdictions. It also engages public, private and non-government sectors. Co-morbidities are commonplace, particularly drug and alcohol problems among younger people. Governments in Australia have traditionally taken responsibility for policy, programs and services, either as direct service providers or through contracting outputs from others. Yet the evidence indicates that for people with a mental illness, the best solutions are often not found in government but in the community and in organisations outside of government. New organisations and new structures are attempting more holistic management approaches, combining clinical care, community support, housing, employment and other services. This paper considers some of these new models in the light of existing evidence. The key challenge facing continued reform in mental health is not uncertainty regarding programs or services, but rather how to drive coordinated care for consumers across departments, governments and providers. This review will highlight the key changes that must be made for the benefit of the millions of Australians with a mental illness. Such changes need to empower users of care systems to choose options that actively support coordinated and efficient care delivery systems.

Monitoring Pulmonary Rehabilitation and Long Term Oxygen Therapy for People with Chronic Obstructive Pulmonary Disease (COPD)

Chronic obstructive pulmonary disease (COPD) is a major cause of death and disability in Australia. While pulmonary rehabilitation and long term oxygen therapy are recommended treatments for COPD, there is currently no national information about the supply and use of these therapies. This report, by the Australian Institute of Health and Welfare (AIHW), outlines a proposed approach to monitoring access to, and utilisation of, these therapies, by capitalising on existing data sources and identifying data development opportunities. (AIHW media release 20 November 2013)

A Problem Worth Solving: the Rising Cost of Musculoskeletal Conditions in Australia

This report details the rising cost of musculoskeletal conditions in Australia and makes a case for why there needs to be a proactive, strategic response.
Key findings include:

• $55.1 billion cost to the Australian economy, including direct health costs, lost productivity and reduced quality of life
• 6.1 million Australians already affected, of which 58% are of working age in peak income earning years (25-64 years)
• 43% growth in musculoskeletal cases projected over the next two decades, including a surge in older Australians living with the conditions

This report was produced by Arthritis Victoria and Osteoporosis Victoria based on analysis by Deloitte Access Economics (APO 17 October 2013)

Prostate Cancer in Australia

This is the first comprehensive national report on prostate cancer in Australia by the Australian Institute of Health and Welfare (AIHW). It presents an overview of the condition and analysis of key summary   measures including incidence, mortality and survival. Findings include: - Prostate cancer is the most commonly diagnosed cancer in Australia (excluding non-melanoma skin cancer), with 21,808 new diagnoses in 2009. - Prostate cancer is the fourth leading cause of mortality among Australian males, with 3,294 deaths from prostate cancer in 2011. - Around 9 in 10 (92%) males diagnosed with prostate cancer survive 5 years from diagnosis. This is higher than for all cancers (65%). (AIHW 14 November 2013)

Palliative Care Services in Australia 2013

Palliative care services in Australia 2013 is the second in a planned series of annual reports by the Australian Institute of Health and Welfare (AIHW) providing a detailed picture of the national response to the palliative care needs of Australians. Information from a range of data sources from 2011-12 and where indicated, 2010-11 are presented, as are changes over time. There were almost 54,500 palliative care-related separations reported in public and private hospitals in 2010-11. Almost $3.5 million in Medicare Benefits Schedule payments was paid for palliative medicine specialist services in 2011-12 (AIHW 15 November 2013)

Role of Traditional Medicine Practice in Primary Health Care within Aboriginal Australia

This literature review by Stefanie Oliver, published in the Journal of Ethnobiology and Ethnomedicine, attempts to identify and examine, both qualitatively and quantitatively, traditional medicine practices within Aboriginal Australia today. The practice of traditional Aboriginal medicine within Australia is at risk of being lost due to the impact of colonisation. Displacement of people from traditional lands as well as changes in family structures affecting passing on of cultural knowledge are two major examples of this impact. Prior to colonisation traditional forms of healing, such as the use of traditional healers, healing songs and bush medicines were the only source of primary health care. It is unclear to what extent traditional medical practice remains in Australia in 2013 within the primary health care setting, and how this practice sits alongside the current biomedical health care model. An extensive literature search was performed from a wide range of literature sources in attempt to identify and examine both qualitatively and quantitatively traditional medicine practices within Aboriginal Australia today. Whilst there is a lack of academic literature and research on this subject the literature found suggests that traditional medicine practice in Aboriginal Australia still remains and the extent to which it is practiced varies widely amongst communities across Australia. This variation was found to depend on association with culture and beliefs about disease causation, type of illness presenting, success of biomedical treatment, and accessibility to traditional healers and bush medicines. Traditional medicine practices were found to be used sequentially, compartmentally and concurrently with biomedical healthcare. Understanding more clearly the role of traditional medicine practice, as well as looking to improve and support integrative and governance models for traditional medicine practice, could have a positive impact on primary health care outcomes for Aboriginal Australia. (APO 2 July 2013)

Health in Australia: a quick guide

Health in Australia: a quick guide has been published by Amanda Biggs of the Parliamentary Library as an overview of Australia's complex health system.  It looks at the role of the different tiers of government, private health insurance, how much we spend on health care, how our health outcomes compare with that of other nations and our health workforce.  It also includes useful links to further information and resources.

New US guidelines on cholesterol treatment

Following on from the recent Australian media debate over the use of statins, the major heart organisations in the USA have just released new guidelines, published in the Journal of the American College of Cardiology:  2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines [J Am Coll Cardiol. 2013;():. doi:10.1016/j.jacc.2013.11.005].

A useful summary of the changes in the US can be found in Tuesday's New York Times article, Experts reshape treatment guide for cholesterol, by Gina Kolata.  Doctors are encouraged to prescribe statins to high risk patients (those who have diabetes or have had a heart attack), and to those who have very high levels of LDL cholesterol.  Others should be considered for statin therapy if, using a new risk calculator their risk of a heart attack or stroke in the next 10 years is at least 7.5 percent.  There is less emphasis on lowering cholesterol by specific amounts, and as Kolata reports, "It is not clear whether more or fewer people will end up taking the drugs under the new guidelines, experts said. Many women and African-Americans, who have a higher-than-average risk of stroke, may find themselves candidates for treatment, but others taking statins only to lower LDL cholesterol to target levels may no longer need them."

Treatment needs of pregnant women who are alcohol dependent

It's time to have the conversation: understanding the treatment needs of women who are pregnant and alcohol dependent is a report by Lucy Burns and Courtney Breen from the National Drug and Alcohol Research Centre.  It presents a narrative literature review of treatments available to pregnant women who have alcohol use disorders and findings from interviews with key stakeholders regarding current treatment practices and areas requiring improvement.

The authors found very little evidence-based literature on this topic, but from their research they compiled gold standards for the treatment of alcohol dependence in pregnancy. These standards include the screening of all pregnant women on their alcohol use by health professionals.  Pregnant women who screen positively for alcohol-use disorders should be offered access to treatment and extended hospitalisation post-delivery and birth with help and support from a multidisciplinary team.

The State of the World's Children - UNICEF

The 2013 edition of The State of the World’s Children is dedicated to the situation of children with disabilities. This UNICEF report examines the barriers that deprive children with disabilities of their rights and keep them from participating fully in society, such as inaccessible buildings, dismissive attitudes, and invisibility in official statistics.  It also lays out some of the key elements of inclusive societies that respect and protect the rights of children with disabilities, adequately support them and their families, and nurture their abilities, so that they may take advantage of opportunities to flourish and make their contribution to the world.

Tattoo ink and cancer

Photo from the ABC

Is there a link between tattoo inks and cancer?  Last year, a literature review, Tattoos, inks, and cancer by Kluger and Koljonen was published in Lancet Oncology. The authors concluded that "The number of skin cancers arising in tattoos is seemingly low, and this association has to be considered thus far as coincidental." Recently the issue has been raised again in the media, with Ian Olver, Clinical Professor of Oncology at Cancer Council Australia, penning a piece in The Conversation, To dye for?  Jury still out on tattoo ink causing cancer.  Olver concludes that more research is needed to find out whether the pigments and metallic elements in some tattoo dyes are used in great enough quantities to cause cancer.  He says individuals must weigh the risk and benefits themselves.

ABC Radio's Background Briefing also recently featured a program on the toxicity of inks and the lack of health regulations surrounding tattooing. Epidemic of Ink reported that tattoo ink containing polyaromatic hydrocarbons (PAHs) at levels above European guidelines have been found in Australia in a preliminary study by the National Research Centre for Environmental Toxicology. You can read a summary of the program or download the one hour investigation from their website.

Significant gaps in stroke care - report

The increasing number of people surviving strokes is leading to a crisis in service provision as the health and community support systems struggle to keep pace with demand. A new report, The needs of stroke survivors in Australia was released recently by the National Stroke Foundation.  It shows Australians are struggling every day due to a lack of access to essential support – a situation that is set to worsen as the number of stroke survivors grows. The report shows services are fragmented and access is dependent on where survivors live.   

Pain management webpage

The Australian Medicare Local Alliance has launched a webpage dedicated to pain management education. It includes information about forthcoming online education programs, a webinar series for multidisciplinary care teams including GPs, nurses and allied health care professionals, and a symposia scheduled in capital cities early next year for nurses, physiotherapists, clinical psychologists and pharmacists.  

At present, there are useful links to pain resources, the National Pain Strategy, other education resources for health professionals, and consumer information.

Cholesterol and statins debate

The ABC recently aired a two-part program on Catalyst entitled The Heart of the Matter.  The first program, Dietary Villains, questioned the role of saturated fats in causing high cholesterol and cardiovascular disease, and the second program, Cholesterol Drug War, asked if statins really reduce your risk of heart disease.  The result has been consternation among some of Australia's medical community, with the ABC's own health specialist Norman Swan claiming that the Catalyst program could cause people to die if they gave up taking statins on the basis of this program (see the Sydney Morning Herald report on 4 November).

The ABC's Health Report (presented by Norman Swan) made an alternative case in their program this week, The Cholesterol and Statin Debate, which included an interview with Professor Peter Clifton.  Another interesting article which attempts to unravel the arguments and includes links to clinical trials and other evidence-based material was published this week in The Conversation by Justin Coleman from Griffith University - Viewing Catalyst's cholesterol programs through the sceptometer . Be sure to scroll down to the comments below where the conversation continues.

Health Libraries - Worth Every Cent and More

Health Libraries Inc in Victoria and Health Libraries Australia commissioned  SGS Economics and Planning to investigate the return on investment of health library and information services in Australia, and their report has just been published. Worth every cent and more: an independent assessment of the return on investment of health libraries in Australia used surveys and case-studies to indicate that health libraries return $9 for every $1 invested.

This is considered to be a conservative estimate of  libraries' real worth as, for example, it takes into account the time saved by medical practitioners in searching for answers, but it does not take into account the improved quality of the results supplied by trained information specialists. It looks at how much it would cost users to have to buy the information they gain for free from the library, but it does not assess the savings achieved by library staff negotiating advantageous prices with information suppliers.

Indigenous women's health portal

The new Indigenous women’s health portal, located on the Australian Indigenous HealthInfoNet website, and partnered with Jean Hailes for Women's Health, aims to provide the indigenous women's health workforce and related health workers with access to quality information. 

The content of this portal is relevant to the health and wellbeing of women at a range of different life stages. The topics were chosen with input from Aboriginal and Torres Strait Islander health workers and a range of health professionals working in the area of Indigenous women's health. At this stage there is a core of evidence based facts and publications on such topics as menopause, menstruation, pregnancy and polycystic ovary syndrome.

Diabetes and disability

Diabetes anddisability: impairments, activity limitations, participation restrictions andcomorbidities is an AIHW report using data from the Australian Bureau of Statistics' Survey of Disability, Ageing and Carers 2009. People with diabetes were twice as likely to have a disability (39% compared with 17%) and almost 3 times as likely to have a severe or profound limitation (14% compared with 5%) than people without diabetes. Among working-age people with diabetes and disability, 40% said they were permanently unable to work compared with 20% of people with a disability who did not have diabetes. People with diabetes reported higher rates of high blood pressure, high cholesterol, heart disease, stroke, depression, vision loss and kidney related disorders than people without diabetes.

The Third Healthcare Revolution - Sir Muir Gray

Sir Muir Gray recently presented a public lecture in Sydney focusing on health reform and medical practice variation.  He believes we are in the midst of a Third Healthcare Revolution driven by citizens, knowledge and the Internet.  Sir Muir argues that despite the significant clinical advances of the last 50 years, health services are faced with the same persistent problems: patient harm, waste, unwarranted variation, inequity, and failure to prevent the preventable. Health services are also faced with the new challenges of rising demand and resource constraints.

Visit the Australian Commission on Safety and Quality in Health Care site to download the video of the presentation, view the PowerPoint slides, and link to more detailed workshop presentations.

Cancer in Aboriginal and Torres Strait Islander peoples

Cancer in Aboriginal and Torres Strait Islander Peoples of Australia: an overview is a report from the AIHW which brings together the most up-to-date data available from a wide range of sources to present statistics on difference across age, sex and remoteness areas and highlight key issues.  In 2007-2011, the age-standardised cancer mortality rate was 252 per 100,000 for indigenous Australians, compared to 172 for non-indigenous Australians, with lung cancer being the leading cause of cancer death.  Indigenous Australians had a 40% chance of surviving a diagnosis of cancer for at least 5 years, while non-indigenous Australians had a 52% chance.

Mental health research and evaluation project report

Mental health research and evaluation in multicultural Australia: Developing a culture of inclusion has been prepared by Mental Health in Multicultural Australia (MHiMA) for the National Mental Health Commission. This independent report looks at what is known about the mental health of culturally and linguistically diverse (CALD) communities in Australia; whether our mental health research pays adequate attention to cultural and linguistic diversity; and whether national data collections support evidence-informed mental health policy, practice and reform. The authors make recommendations for policy makers, researchers and others.