Young Australians and sexual health

A national survey of Australian high school students in 2013 revealed that although the age in which young people first engage in sexual intercourse has remained fairly stable, the level of STIs has been increasing over recent years.  This and other information is included in a report from the Australian Clearinghouse for Youth Studies (ACYS) in its Face the Facts series: Young Australians and Sexual Health. 

The report suggests that young people are often vulnerable to infection because their condom use is intermittent, with barriers to safe sexual practice often stemming from confusion, embarrassment or lack of preparation.  A critical need for multifaceted and integrated sexual health education is identified.

Dementia care in the acute hospital setting

Alzheimer's Australia has produced a report, Dementia care in the acute hospital setting: Issues and strategies, which identifies a range of strategies to improve the outcomes for people with dementia.  People with dementia experience unacceptably worse clinical outcomes, longer lengths of stay as well as a higher likelihood for readmission compared to people without dementia at a high cost to the health care system.  To improve this situation in acute hospitals, the report outlines urgent issues that need to be addressed. These include:

• Better identification of cognitive impairment in our hospitals
• Increased training for all staff including how to communicate with a person with dementia and how to respond to behavioural and psychological symptoms
• More extensive and systematic involvement of carers as partners in the health care of people with dementia
• The creation of appropriate physical hospital environments to reduce confusion and distress of people with dementia.

Australia's Health 2014

The AIHW's 14th biennial report of the health of our nation has been released.   It combines analytical feature articles on topical health issues with short statistical snapshots in the following areas:    

• Understanding health and illness
• The Australian health system
• How healthy are we?
• Leading types of ill health
• Health behaviours and risks
• Health through your life
• Indigenous health
• Preventing and treating ill health
• Indicators of Australia's health.

Download the full report here.

Stroke - Symptoms, knowledge and education

The following articles from the International Journal of Stroke are available free full text online:

What is stroke symptom knowledge?, Ian Mosley, Marcus Nicol, Geoffrey Donnan, Amanda G. Thrift, and Helen M. Dewey, Volume 9, Issue 1, January 2014.

Comparison of stroke warning sign campaigns in Australia, England, and Canada, Kym Trobbiani, Kate Freeman, Manuel Arango, Erin Lalor, Damian Jenkinson, and Amanda G. Thrift, Volume 8, Issue Supplement A100, October 2013.

Educational campaign on stroke in an urban population in Northern Germany: influence on public stroke awareness and knowledge, Hans Worthmann et al.,Volume 8, Issue 5, July 2013

The Elders’ Report into Preventing Indigenous Self-harm & Youth Suicide

The rate of youth suicide and self-harm in Indigenous communities across Australia is now the highest in the world. This report argues for a different approach to the issue: one that reconnects young Indigenous people to their culture. And it is based on the experience of Elders from communities from Cape York, to the Kimberley on what needs to be done to address this crisis.
You can access the full report "The Elders’ Report into Preventing Indigenous Self-harm & Youth Suicide" from the "Be part of the healing" website.

 

Mirror, Mirror on the Wall, 2014 - comparing health systems internationally

Recently released is the international Commonwealth Fund report - Mirror,Mirror on the Wall: How the performance of the US Health Care System compares internationally – which ranks 11 health systems across the globe on a range of criteria. Although Australia ranks at number 4 overall, our lowest rankings are on timeliness of care, cost and access. You can read the full report here.

Poor nutrition leads to development of chronic diseases

International research involving the University of Adelaide has shown for the first time that poor nutrition - including a lack of fruit, vegetables and whole grains - is associated with the development of multiple chronic diseases over time. 

The results of the study, which looked at health, diet and lifestyle data of more than 1000 Chinese people over a five-year period, are published in this month's issue of the journal Clinical Nutrition. "Risk factors such as smoking, lack of physical activity and nutrition are already known to be linked to the development of chronic disease. But this is the first time research has shown that nutrition itself is directly associated with the development of multiple chronic diseases over time," says study co-author Dr Zumin Shi, from the University of Adelaide's School of Medicine. 

You can read the abstract here; Clinical Nutrition Volume 33, Issue 3, June 2014, Pages 513–520 and ask your library for access to full text.

Driving and your health

As little as two hours a day behind the wheel is a potential risk factor for a range of poor health behaviours and outcomes. People who drive for two hours or more per day are more likely to smoke, to be obese, and to be less physically active. This journal article from PLOS ONE uses data from the Social, Economic, and Environmental Factor Study conducted in New South Wales in 2010 by the Sax Institute, and is freely available to read and download. 

Driving: A Road to Unhealthy Lifestyles and Poor Health Outcomes, PLOS ONE, June 09, 2014  DOI: 10.1371/journal.pone.0094602

Management of hip fracture in older people

The NSW Agency for Clinical Innovation (ACI) has developed the Minimum Standards for the Management of Hip Fracture in the Older Person in order to improve the outcomes for patients with fractured hips requiring surgery and management.  Seven standards have been identified:

1. Orthogeriatric clinical management of each patient
2. Optimal pain management
3. Surgery is within 48 hours and in the daytime
4. Surgery is not cancelled
5. Commencement of mobilisation within 24 hours of surgery
6. Refracture prevention
7. Local ownership of data systems and processes to drive improvements in care

Improving our health system - Deeble Institute

Two new issue briefs from Krister Partel at the Deeble Institute for Health Policy Research (at the Australian Healthcare and Hospital Association) ask what are the best ways to improve our health system.

Can weimprove the health system with performance reporting? The answer seems to be yes if health system targets and performance monitoring are properly developed and implemented.

Can we improve the health system with pay-for-performance?  The author questions the value of these programs as there is little convincing evidence for their efficacy.  

Autism in Australia 2012

The Australian Bureau of Statistics has released a report on the state of Autism in Australia in 2012. Autism is defined as "lifelong developmental disabilities characterised by marked difficulties in social interaction, impaired communication, restricted and repetitive interests and behaviours and sensory sensitivities", and in 2012 there were an estimated 115,400 Australians with autism, which was a 79% increase since the 2009 estimate.  In 2012, males were four times more likely than females to have the condition, mirroring similar gender differences overseas.

The report goes on to discuss the impact autism has on people's lives, including their education, labour force participation and their assistance requirements and receipt.

Australian Bureau of Statistics, 4428.0 - Autism in Australia, 2012, released June 2014

Medical cannabis background paper

Elsa Koleth from the NSW Parliamentary Research Service has prepared this background paper on Medical Cannibis.  The paper considers the key legal issues involved, including the relationship between Commonwealth and State laws.  It then discusses parliamentary, scientific and other legal research, and includes the state of affairs in other countries such as the USA. Canada and Israel.  There is an extensive bibliography covering 2008-2014 literature on every possible aspect.

Effect of weekend physiotherapy on length of stay - Australian Health Review

An Australian regional hospital study has shown that increasing the provision of physiotherapy services after TKR has the potential to reduce hospital length of stay.  Effect of weekend physiotherapy provision on physiotherapy and hospital length of stay after total knee and total hip replacement aimed to investigate the effects of a change from a 5 to a 7 day a week physiotherapy service on patients who received either a TKR or a THR. 

Australian Health Review 38(3) 265-270  Published: 8 May 2014  Zoe L. Maidment A B , Brenton G. Hordacre B and Christopher J. Barr B C  

Head and neck cancers in Australia

The Australian Institute of Health and Welfare has issued a report, Head and neck cancers in Australia, which presents the latest available information on incidence, mortality, survival and hospitalisations. 

The total number of head and neck cancers diagnosed in 2009 was 3,896 accounting for 3.4% of all cancers diagnosed in that year.  In 2011, the total number of deaths from head and neck cancers was 944 accounting for 2.2% of all deaths from cancer.  In 2006–2010, 5–year relative survival was 68.2% for all head and neck cancers combined and in 2011–12 there were 8,478 hospitalisations where head and neck cancer was the principal diagnosis.

New database of evidence summaries in management

The Center for Evidence Based Management (CEBMa) in the Netherlands has constructed a freely accessible, online database of evidence summaries in the field of management.  CEBMa is committed to making summaries available on the most trustworthy scientific research on topics relevant to management practice, including systematic reviews, meta-analyses, rapid evidence assessments (REAs) and critically appraised topics (CATs).  

Stigma of mental illness - lecture podcast

Professor Norman Sartorius, President of the Association for the Improvement of Mental Health Programs and former director of the World Health Organisation’s Division of Mental Health presented a lecture on The Stigma of Mental Illness, broadcast recently on ABC Radio's Big Ideas series.  About one in five Australians experiences a mental illness at some stage of their life, and Professor Sartorius argues that stigma remains the main obstacle to progress in the field of mental health.  He asks why stigma is so difficult to overcome, provides many disturbing examples, and discusses ways we can develop interventions against it. 

You can download the audio, or listen online at the link above.

The Australian Indigenous Alcohol and Other Drugs Knowledge Centre

The Knowledge Centre website has been set up by the Australian Government to build on and enhance the Australian Indigenous HealthInfoNet site. As well as superseding the HealthInfoNet’s coverage of alcohol and other drugs the Knowledge Centre has much wider responsibilities, including workforce and community support and the collation and provision of policy-related advice.  

Developed and operated by Edith Cowan University, the resource aims to provide the evidence base to reduce harmful substance use among Aboriginal and Torres Strait Islander peoples. It provides access to a comprehensive collection of relevant, evidence-based, current and culturally appropriate alcohol and other drug (AOD) knowledge-support and decision-support materials and information for individuals, communities, practitioners and policy makers that can be used in the prevention, identification and management of alcohol and other drug use in the Aboriginal and Torres Strait Islander population.

Developing collective leadership for health care

This paper from The King’s Fund in the UK argues that collective leadership – as opposed to command-and-control structures – provides the optimum basis for caring cultures. Collective leadership means everyone taking responsibility for the success of the organisation as a whole – not just for their own jobs or area. This contrasts with traditional approaches focused on developing individual capability.  It also implies that all staff welcome feedback, and treat complaints and errors as opportunities for learning.  There should be collective openness to and learning from errors, near misses and incidents.

The interaction between collective leadership and cultures that value compassionate care are explained by drawing on wider literature and case studies of good organisational practice. The main characteristics of a collective leadership strategy and the way to develop it are outlined.   

Substitution of physicians by nurses in primary care

Substitution of physicians by nurses in primary care: A systematic review and meta-analysis is a recent study published as open access in BMC Health Services Research.  In many countries the substitution of physicians by nurses has become common, especially for chronic and multi-morbid patients. This research explored the evidence on the clinical effectiveness and care costs of this practice in primary care by reviewing and analysing the literature on the subject.  The results suggest that "Nurse-led care seems to have a positive effect on patient satisfaction, hospital admission and mortality".  Recommendations are made for further, more rigorous research on the subject.

BMC Health Services Research 2014, 14:214  doi:10.1186/1472-6963-14-214 Published: 12 May 2014

E-mental health training

This new CPD endorsed online learning package is available from ReachOut.com, the online youth mental health tool of the Inspire Foundation.  The package is aimed at health professionals and provides practical tools for understanding the role of e-mental health services and using them to help young people. It covers four essential areas: the role of online services; using online communities in your work; using mental health websites and online programs in your work; and referring to online counselling and treatment services.  

Euthanasia politics in Australian State Parliaments

The Future of euthanasia politics in Australian State parliaments is a study of the current legislative attempts to legalise voluntary euthanasia in South Australia and Tasmania.  The author, Alison Plumb, from ANU, reviews the status of bills being considered and the activities of various interest groups and professional organisations in order to identify the likelihood of reform in the near future.  The paper also looks at the power of the medical profession in Australian politics in relation to this issue of, as Plumb terms it, "contemporary morality politics".

Global Burden of Disease Study 2013 - obesity and overweight analysis

New figures on the Global Burden of Disease were published recently in The Lancet, Global, regional, and national prevalence of overweight and obesity in children and adults during 1980—2013: a systematic analysis for the Global Burden of Disease Study 2013.  It shows rather alarmingly that Australia and New Zealand have the greatest increases in obesity among high-income countries.  Since 1980, Australia has seen a 28% increase in obesity in adult men and a 30% increase in adult women. The prevalence of overweight and obesity has increased in children and adolescents in developing countries from 8·1% to 12·9% for boys and from 8·4%  to 13·4% in girls. In adults, estimated prevalence of obesity exceeded 50% in men in Tonga and in women in Kuwait, Kiribati, Federated States of Micronesia, Libya, Qatar, Tonga, and Samoa.

The authors of this extensive study conclude that "Not only is obesity increasing, but no national success stories have been reported in the past 33 years. Urgent global action and leadership is needed to help countries to more effectively intervene."

Read a summary of the report in The Conversation, "More than 2 billion people worldwide are overweight or obese", by Anna Peeters from the Baker IDI Heart & Diabetes Institute.

Marie Ng et al. The Lancet, Early Online Publication, 29 May 2014 doi:10.1016/S0140-6736(14)60460-8.  Please contact your health library for full text of the study.

Portrayal of indigenous health in the Australian media

The authors of a paper in the International Indigenous Policy Journal describe how negative media stereotyping in some parts of the Australian media perpetuates the stigma attached to Indigenous Australians and actually impacts on their health.  In the 12 months of the study, the media's portrayal of Indigenous Australian public health issues was examined, with an overwhelming number of articles (74%) being negative and only 15% positive.  Most negative articles related to alcohol, child abuse, petrol sniffing, violence, suicide, deaths in custody and crime.  The authors advocate that those who seek to "close the gap" should be seeking positive media advocacy by reporting positive stories.

The Portrayal of indigenous health in selected Australian media.  Stoneham ML, Gooman J, Daube M. (2014). International Indigenous Policy Journal, 5(1) 

Managing patients with multiple chronic diseases

A few recently published sources have addressed this issue.  ABC Radio National's Health Report last week reported on the difficulty and expense of treating people with comorbidities in their program, Treatment of patients with chronic heart failure and other multiple chronic diseases.  Norman Swan interviewed one of the authors of a successful South Australian experiment to redesign care for such people, Sepehr Shakib, Director of Clinical Pharmacology at the Royal Adelaide Hospital.  

Shakib and his colleagues have published a paper on this topic in PLoS One,  Guideline compliance in chronic heart failure patients with multiple comorbid diseases: evaluation of an individualised multidisciplinary model of care.  The article by Ho, Caughey and Sepehr is available freely in this open access journal.  

Meanwhile, the UK Department of Health has just published a document proposing changes to the British health system to "Better care for people with 2 or more long term health conditions".

Is sport enough?

The Heart Foundation's Active Healthy Kids Australia has published its annual report, "Is sport enough? 2014 report card on physical activity for children and young people.".  Modelled on a Canadian initiative, this report provides information on the physical activity and sedentary behaviours of Australia's children and young people.  The authors conclude that "while it is encouraging that a large number of children are obtaining some of their weekly physical activity from organised sport, we need to ask ‘Is sport enough?’. If we look at overall physical activity levels as well as physical fitness and obesity levels, then the answer is clearly no."