7 million deaths annually linked to air pollution

In  recently released World Health Organisation statistics,  it is estimated that in 2012 approximately 7 million people died as a result of air pollution exposure. Air pollution is now the world's largest single environmental health risk and by reducing air pollution we could save millions of lives.

Click here to read the new WHO estimates.

Successfully spreading surgical innovation

This report from the Royal College of Surgeons of England looks at the barriers to the uptake of surgical innovations. It is hoped the report will stimulate a more systematic approach to the uptake of surgical
innovation, providing greater certainty and improved benefits for commissioners, clinicians and patients.

From innovation to adoption. Successfully spreading surgical innovation, London: The Royal College of Surgeons of England, 2014  

The Health Consequences of Smoking

Evidence in this new Surgeon General's report shows how smoking contributes to the increased health burden of the nation. Tobacco use in America has halved since the 1964 report, and the collective view of smoking has been transformed from an accepted national pastime to a discouraged threat to individual and public health. Click on the link below to download the full report, print out fact sheets and consumer booklets.

The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General, 2014 

Healthy Bones Australia

Healthy Bones Australia is an initiative of Osteoporosis Australia. The aim of the organisation is "to educate and encourage all Australians to look after their bones and prevent the onset of poor bone health...to encourage Healthy Bones for life."
On the website is a quiz called "Assess your bone health online", and also information on bone health, bone building and what foods are good for bone health.
Click here to go to the website.

Safety Is Personal: Partnering with Patients and Families for the Safest Care

Safety Is Personal: Partnering with Patients and Families for the Safest Care is a call to action for health leaders, clinicians, and policy makers to take the necessary steps to ensure patient and family engagement at all levels of health care.

This report identifies specific action items for health leaders, clinicians, and policy makers to pursue in making patient and family engagement a core value in the provision of health care.
                                                                                                                   

Australasian Health Facility Guidelines

The Australasian Health Facility Guidelines (AusHFG) are an initiative of the Australasian Health Infrastructure Alliance (AHIA). One of the main objectives of this organisation is to assist in producing healthcare facilities that will support the required service delivery needs, models of care and operational policies required by health service providers and funding agencies. It supports organisations to better plan, procure and manage their health capital assets across Australia and New Zealand.

Read the Guidelines here.

Drowning deaths in Australia

Drowning deaths in Australian rivers, creeks and streams: a 10 year analysis is a report from the Royal Life Saving Society Australia.  735 people drowned this way between 2002 and 2012, accounting for 25% of all drowning deaths in Australian waterways during this time.  Rivers claimed the most lives, and 80% of river deaths were males.  When examining rates per 100,000 population, the Northern Territory experienced the highest average annual rate of river drowning deaths with a rate of 1.81 compared to a national annual average of 0.35.  Indigenous people drowned at a rate of 1.58 per 100,000 population in rivers, a rate that is 4.4 times that of the general population.

Almost three quarters of people who drowned in rivers did so within 100kms of their home postcode. "This provides strength to the argument that public awareness and drowning prevention strategies should be targeted at the local community level to ensure greatest efficacy."  A high rate of people drowning in floodwaters and under the influence of alcohol and other substances lends further weight to the argument for education in the risks and hazards of river use. 

Advance care directives in NSW - summary paper

This paper from the NSW Parliamentary Research Service, summarises the current policies and public debates about end-of-life care in New South Wales.  The Advance Care Directives e-brief by Lenny Roth looks at the history and arguments in favour of Advance Care Planning and presents the scarce evidence available about the reason for low uptake and outcomes.  There is a summary of the policy and law in NSW, with a comparison to other States and Territories in Australia.

WHO MiNDbank - resources in mental health, disability and more

A very useful website for research on mental health, substance abuse, disability and human rights  is the World Health Organisation's MiNDbank.  Here you can find national mental health, substance abuse and disability related policies around the globe, as well as strategies and laws relating to these subjects as well as lots of information on more general human rights and general health.  There is now information on children and older people and you can browse by country or source.

Evidence & Policy journal - free during May

Evidence & Policy: a Journal of Research, Debate and Practice is published by Policy Press at the University of Bristol.  The publishers have decided to offer free access during May to all their issues and articles since 2005.

The journal aims to provide "comprehensive and critical assessment of the relationship between research evidence and the concerns of policy makers and practitioners, as well as researchers".  

National key performance indicators for Aboriginal and Torres Strait Islander primary health care

This report from the Australian Institute of Health and Welfare presents data for 19 ‘process of care’ and ‘health outcomes’ indicators which focus on the prevention and management of chronic disease, and maternal and child health, Aboriginal and Torres Strait Islander people. It is the first national report on the

This is the first national report on the Indigenous primary health-care national Key Performance Indicators (nKPIs) data collection and covers the period June 2012 to June 2013.  

The 19 indicators presented focus on chronic disease prevention and management and on maternal and child health. These are two key areas for achieving the objective of closing the gap in life expectancy between Aboriginal and Torres Strait Islander Australians and non-Indigenous Australians. Over the period covered, improvements were seen for most of the process of care indicators and organisations in Queensland and the Northern Territory performed better against almost all process of care indicators. The analysis also shows that "well-established Continuous Quality Improvement programs make a positive difference".  

Interventions to improve safe and effective medicines use by consumers

This overview of systematic reviews has recently been published by by the Cochrane Collaboration. Researchers  reviewed the evidence from 75 systematic reviews up to March 2012  about the effects of interventions to improve safe and effective medicines use by consumers, irrespective of disease, medicine type, population or setting. 

The results suggest that although there are many different potential ways through which consumers' use of medicines could be targeted to improve outcomes, no single strategy worked across all settings. Some of the strategies that appear to improve medicines use include medicines self-monitoring, simplified dosing regimens and directly involving pharmacists in medicines management.

Ryan R, Santesso N, Lowe D, Hill S, Grimshaw J, Prictor M, et al. Interventions to improve safe and effective medicines use byy consumers.  Cochrane Database Syst Rev 2014;4:CD007768

The Budget and how it affects the health sector

The Federal Government handed down its budget this week.  What are the implications for the health sector? The Government's own precis of how their budget affects health is explained in this document: Budget 2014-15: health overview.   Medical research is one area to receive a boost, with a $20 billion future fund earmarked for this purpose.

An interesting analysis of other possible future implications for changes to health in Australia as a result of the budget was published in The Conversation:   Federal budget 2014: health experts react.   Stephen Duckett, from the Grattan Institute; Anne-marie Boxall, University of Sydney; Mike Daube, Curtin University, and Philip Clarke from the University of Melbourne look at the changes likely to Medicare locals, preventative health and pharmaceuticals.

Real-life Effectiveness and Topical Psoriasis Treatment

The Journal of the European Academy of Dermatology and Venereology has published a free online virtual issue titled "Real-life Effectiveness and Topical Psoriasis Treatment".  Psoriasis is a common, chronic relapsing/remitting immune-mediated skin disease characterized by red, scaly patches, papules, and plaques, which usually itch. The skin lesions seen in psoriasis may vary in severity from minor localised patches to complete body coverage. The disease affects 2–4% of the general population.

Journal of the European Academy of Dermatology and Venereology. Special Issue: Real-life Effectiveness and Topical Psoriasis Treatment. Volume 28, Issue Supplement s2, May 2014.

Patient Experience Journal

The first issue of the Patient Experience Journal (PXJ) has been published. This is a new international open access journal focused on the research and proven practices around understanding and improving patient experience.  Some of the topics in this first issue include:

• Expanding the dialogue on patient experience (Jason A Wolf)
• Concern for the patient’s experience comes of age (Irwin Press)
• Defining Patient Experience (Jason A Wolf et al.)
• How does patient experience fit into the overall healthcare picture? (Karen Luxford and Sue Sutton)
• Evaluation and measurement of patient experience (Sherri L LaVela and Andrew S Gallan)
• “Working the system”: The experience of being a primary care patient (Michelle L A Nelson et al. 
• A daughter’s frustration with the dearth of patient- and family-centered care (Cindy Brach)
• Patients and families as partners in safety, quality, and experiences of care (Amy Jones and Kathy Dutton)
• Transforming the patient experience: bringing to life a patient-centred interprofessional collaborative practice model of care at Kingston General Hospital (Anndale McTavish and Cynthia Phillips)
• Improving the patient experience through provider communication skills building (Denise M Kennedy, John P Fasolino, and David J Gullen)
• Physician-led patient experience improvement efforts: The CONNECT program, an emerging innovation (Harris P Baden and Jennifer E Scott)

Patient Experience Journal Volume 1, Issue 1(2014)

Kidney Disease fact sheet

Better Health Channel on behalf of the Victorian Department of Health has published a fact sheet on Kidney Disease which has been produced in consultation with Kidney Disease Australia. The fact sheet also gives links to information on dialysis, kidney failure and blood pressure.

Sleep Apnoea / Sleep-disordered Breathing and Heart Failure

Read the latest Virtual Issue and Special Issue from the European Journal of Heart Failure. Sleep Apnoea / Sleep-disordered Breathing and Heart Failure is free online.

Ageing and body image - qualitative study

Research has shown a link between body dissatisfaction and wellbeing, and ageing causes changes to the body that can be challenging.  The authors of the Journal of Health Psychology article, "Looking age-appropriate while growing old gracefully: a qualitative study of ageing and body image among older adults" lament the lack of evidence on the effect of body image among older people.

In this study, six focus groups were conducted with people aged between 65-92.  Four themes emerged:  the belief that appearance is an indication of capability and identity; that physical ability is more important than appearance; that there are pressures to age 'gracefully'; and that there are cultural and gender differences and implications.  The findings indicated that body image for this age group can have a significant bearing on wellbeing and that further research on the subject is needed.

Jankowski GS, Diedrichs PC, Williamson H, Christopher G, Harcourt D. Journal of Health Psychology, doi: 10.1177/1359105314531468 (2014).  Free online.

People with cancer - discrimination and financial burden

Making the law work better for people with cancer is the latest report from a joint project between the
McCabe Centre for Law and Cancer and Cancer Council Victoria. Their aim is to examine the laws and policies that impact on Victorians with cancer as well as their families.  Areas they have looked at include:

• access to treatment - those who live furthest from metropolitan areas fare worse and have an increased financial burden in their cancer care
• employment - sick leave, discrimination and returning to work issues
• insurance - discrimination and genetic testing in insurance

The Director of the McCabe Centre, Jonathan Liberman, wrote a piece in The Conversation last week which summarised the report:  Reducing discrimination and financial burdens for people with cancer.

Trends in coronary heart disease mortality

Trends in coronary heart disease mortality: age groups and populations has just been published by the Australian Institute of Health and Welfare.  It looks at differing trends in the decline of CHD mortality amongst age groups, Aboriginal and TSI status, geographic location and socioeconomic status. Some of the findings were:

• For men and women aged 70 years and over, who are most at risk of CHD death, mortality declines have continued to improve and are currently -5.1% per year.  
• CHD mortality rates for Aboriginal and Torres Strait Islander people remain higher than for other Australians 
• Overall trends in CHD mortality decline were less favourable among people living in the most remote areas of Australia 
• Overall trends in CHD mortality decline were less favourable among the lowest socioeconomic group
• For men and women in younger age groups, the CHD mortality gap narrowed between the lowest and highest SES groups, whereas the gap widened for those aged for 70 or over. 

Aged care in Australia - two reports

The ARC Centre for Excellence in Population Ageing Research have released two new research briefs:

Aged Care in Australia: part I - policy, demand and funding looks at the demand and funding of both formal and informal care, taking a top-down approach.

Aged Care in Australia: part II - industry and practice describes care recipients, providers, the workforce and access and quality issues.  On workforce, the researchers noted that staffing was the largest cost item for aged care providers (64 per cent) and predicted the workforce would need to increase from the current 350,000 to between 830,000 and 1.3 million by 2050 to meet the future demand for services.

Vaccination and the law

Who has the final word on whether an individual child is vaccinated and when can disputes about vaccination end up in court?

A recent program on ABC Radio National's Law Report, Vaccination and the Law, included an interview with Professor Cameron Stewart from the University of Sydney Law School who discussed cases where the courts have stepped in to resolve disagreements between parents over the vaccination of their child.  He also referred to some recent cases where even though both parents did not want their child to be vaccinated, the courts have deemed that as the mother had Hepatitis B, the child was exposed to significant risk and should be vaccinated.  

John Wardle, Research Fellow with the University of Technology, Sydney, discussed the need for better education for parents, and the changes in NSW legislation this year where parents have to have their objections to vaccination recorded and signed by an immunisation provider before their non-vaccinated child can enrol in a child care centre. 

Snakebite & spiderbite clinical management guidelines

This updated guideline provides information to assist clinicians in the assessment, decision making and clinical management of patients with suspected or confirmed snakebite or spiderbite.
Snakebite and Spiderbite Clinical Management Guidelines 2013- Third Edition (released March 2014)

Controlling costly care: a billion dollar hospital opportunity

Hospital spending is the fastest growing area of government spending, and it will continue to increase with new technologies and an ageing population. In this report published by the Grattan Institute, it is suggested sorting out inefficiencies in public hospital systems is a good place to start. In one example it is found that the difference in the cost of a hip replacement can vary up to $16,000 between different hospitals. The authors suggest that this money could be used for different purposes.

Controlling costly care: a billion-dollar hospital opportunity. Stephen Duckett and Peter Breadon. Melbourne: Grattan Institute; March 2014

Why leadership-development programs fail

This issue of the McKinsey Quarterly looks at why leadership initiatives fail. The report identifies the four most common reasons that programs fail and gives tips to overcome them.

Why leadership-development programs fail.  Sidestepping four common mistakes can help companies develop stronger and more capable leaders, save time and money, and boost morale. 

January 2014 | byPierre Gurdjian, Thomas Halbeisen, and Kevin Lane. Mckinsey Quarterly

The New Silence: family breakdown and child sexual abuse

A number of studies have found that children who do not live with both biological parents are more likely to be sexually abused, compared to children who live in intact families. "Step and single-parent families accounted for only one-third (33%) of all children in the United States but accounted for more than two-thirds (66.8%) of all children who were sexually abused."

This publication suggests that Australia run a campaign similar to those for anti-smoking and anti-drink driving to educate citizens, promote certain values, and change attitudes and behaviours. Author Jeremy Sammut states "A public information campaign that advertised the risks to children posed by family breakdown would end the new silence that hides the culturally unfashionable truth about the family."

Read this full report by Jeremy Sammut from the Centre for. Independent Studies. (Issue Analysis 142)
The New Silence: family breakdown and child sexual abuse

Wellbeing: why it matters to health policy

This document published by the UK Department of Health, looks at why wellbeing matters to health through out someone's life, and what policy makers can do about it. Health is the top thing people say matters to their wellbeing. For health professionals, understanding the different parts of personal wellbeing may offer insights into how their own work fits into a wider context and how what they do can influence wellbeing.

Wellbeing: why it matters to health policy. Great Britain: Department of Health

Commission of Audit - health related recommendations

The National Commission of Audit's somewhat controversial list of recommendations to the Australian Government released yesterday included a number of areas related to health.  This is unsurprising as health is one one the government's largest areas of expenditure.

Among many responses and media reports, The Conversation has gathered some expert opinion on the various aspects covered, including the Pharmaceutical Benefit Scheme, private health, the National Disability Insurance Scheme, preventive health and health reform.  Stephen Duckett from the Grattan Institute gave an overview, and other contributors were Anthony Harris, Jim Hyde, Karen Soldatic, Philip Clarke and Rob Moodie.  Some of the Commission's suggestions were welcomed enthusiastically, while others were criticised.

Read the article, Commission of Audit's health hit list: experts respond 

Australia's Hospital Statistics 2012-13

The Australian Institute of Health and Welfare has released Australia's hospital statistics 2012-13 which reports that there were approximately 5.2 million same-day acute separations and 3.7 million overnight acute separations from hospitals in that time.

Hospitals also dealt with 7.9 million non-admitted emergency presentations.  There were 1338 hospitals in Australia in that time, with public hospitals accounting for about 68% of beds.   The report also gives statistics on hospital expediture, staffing and surgery.

Effectiveness of general practice-based health checks

An article published recently in the British Journal of General Practice, Effectiveness of general practice-based health checks: a systematic review and meta analysis concluded that general practice-based health checks are associated with small but statistically significant improvements in outcome, especially among high-risk patients, but most studies were not designed to assess mortality.

A discussion of the study was published in The Conversation last week by Chris Del Mar from Bond University, Should you get general health check-ups? In his analysis, Del Mar outlines the historical background of annual health checks and how they have gradually become standard practice. A 2012 Cochrane review found no benefits in morbidity or mortality for annual health checks, but the current study gives the practice a more positive purpose.

British Journal of General Practice 2014 Jan; 64(618): e47-53. doi: 10.3399/bjgp14X676456. - Contact your health library if you have trouble accessing the fulltext.

Evidence-based workforce planning in Australia

Authors from Health Workforce Australia have had an open access article published in the journal Human Resources for Health, which describes the background, methods and results of their Health Workforce 2025 project.  How evidence-based workforce planning in Australia is informing policy development in the retention and distribution of the health workforce explains how HWA was set up by the Council of Australian Governments as the national agency to progress health workforce reform.  The authors present the actions being taken to respond to their findings, especially in regard to innovation, immigration, training capacity and efficiency and workforce distribution.  They conclude by stressing the need for "coordinated, long-term reforms by government, professions and the higher education and training sector for a sustainable and affordable Australian health workforce."

Crettenden IF, McCarty MV, Fenech BJ, Heywood T, Taitz MC, Tudman S. Human Resources for Health, 12:7, DOI: 10.1186/1478-4491-12-7 (2014).