Transition care for older people leaving hospital

Today the Australian Institute for Health and Welfare has published Transition care for older people leaving hospital: 2005-06 to 2012-13. 

This report looks at the Transition Care Program which assisted more than 87,000 people between 2005 and 2013.  81% of the recipients completed their planned care under the program, and of them 76% had improved functional status.  54% of care recipients returned to live in the community, and of these two thirds did not enter residential aged care within 12 months.

AIHW 2014. Transition care for older people leaving hospital: 2005-06 to 2012-13. Aged care statistics series 40. Cat. no. AGE 75. Canberra: AIHW

Updates to mental health services website

The Australian Institute of Health and Welfare's Mental Health Services in Australia website has undergone some significant updates:

• Medicare-subsidised mental health-related services (MBS) 2012-13
• Mental health-related prescriptions (PBS) 2012-13
• updates to the Australian Government expenditure on Medicare-subsidised mental health-related services and subsidised prescriptions 2012-13
• updates to the MBS & PBS data in the state and territory summary tables 

Rapid response systems in hospitals

The incidence of inhospital cardiac arrests (IHCAs) has decreased by more than 50% in those Australian hospitals with rapid response systems (RRSs), according to an article recently published in the Medical Journal of Australia.  Cardiopulmonary arrest and mortality trends, and their association with rapid response system expansion by Jack Chen et al, explains that as RRSs have been progressively introduced since 2002 there has been a coincidental reduction in hospital mortality due to IHCAs and and increased survival to hospital discharge.

One of the paper's authors, Kenneth Hillman, wrote a piece summarising the research in a recent issue of The Conversation: Rapid response teams halve hospital heart attack deaths.

Med J Aust 2014; 201 (3): 167-170. doi: 10.5694/mja14.00019.  Access the full text via CIAP or ask your health librarian. 

Medicinal use of cannabis

The Australian National Council on Drugs (ANCA) has published Medicinal use of cannabis: background and Information paper, which provides an overview of what is known about medicinal cannabis use in Australia and internationally, the current state of the scientific and medical evidence for its use, and issues with the current situation in Australia.

It seems that there is a lack of evidence on this topic, largely due to the fact that it it still illegal in Australia.  "...there is a need to disentangle medical and scientific questions from legal and ideological ones in considering whether and how medicinal cannabis should be used in Australia. This is difficult to achieve, since the range of acts and regulations that control non- medicinal uses of cannabis will necessarily impact on medicinal use."

For more recent information about this topic, see a recent Sydney Morning Herald report by Melissa Healy about a JAMA study, Medical marijuana could reduce painkiller abuse. Also, see the NSW Cancer Council's Medical Use of Cannabis (marijuana) Position Statement. 

National Alcohol and Drug Knowledgebase

The National Alcohol and Drug Knowledgebase (NADK) has been developed by the National Centre for Education and Training on Addiction at Flinders University, with support from the Australian Government Department of Health.  The website "... draws on the highest quality Australian data to provide accurate and easy-to-understand information about alcohol and other drugs."

Information is presented by way of FAQs, with sections on alcohol, cannabis, pharmaceuticals and methamphetamines.  Much of the site is still under construction, but it looks like it will prove to be a valuable resource for quick access to synthesised data in these areas.

Paediatric palliative care website

The NSW Paediatric Palliative Care Program has developed this new website aiming to provide families and health professionals with information about children with life-limiting illness. The parents and carers section includes information about bereavement, keeping memories and support networks.  The health professionals section includes referral information, models of care, symptom management and education.

The program has been developed jointly by the Children's Hospital at Westmead, Sydney Children's Hospital and John Hunter Children's Hospital, along with the NSW Agency for Clinical Innovation (ACI).

Oral health and dental care in Australia

A recent report from the Australian Institute of Health and Welfare highlights the trends in oral health historically.  Oral health and dental care in Australia: key facts and figures, suggests that although there have been some improvements over the long term, there have been some concerns in recent years. For example, although there was a drop in the average number of decayed children's baby teeth from 1977 to 1995, since then there has been a gradual rise.

Dental visiting patterns have generally increased with the proportion of people over 15 who made a dental visit in the previous 12 months increasing from 56% in 1994 to 62% in 2010.  The cost of visiting the dentist remains a concern for some people, and there has been a growth in the supply of dental practitioners in recent years.

Contradictory studies on salt consumption effects

Bruce Neal, from the St George Institute of Global Health, has recently written "Best to ignore salt claims..." in The Conversation about conflicting studies which have just been published in the New England Journal of Medicine.  One of the studies was from the Global Burden of Disease program, finding that too much salt was causing millions of premature deaths and was especially related to high blood pressure.  The other study was a Prospective Urban and Rural Epidemiological (PURE) study, involving a large data set from around the world.  This cohort study found that high salt intake was unlikely to be related to blood pressure and suggested that World Health Organisation salt intake guidelines were set too low.

Neal argues that the PURE study was flawed in its findings, and that "Randomised trials of salt reduction show clear benefits on blood pressure, the leading cause of premature death in the world. This is the best evidence we have to date and it’s the evidence that should drive health policy".

Find the reports of the studies, as well as an editorial, in the New England Journal of Medicine, August 14 edition, volume 371, no. 7.  Full text can be obtained through CIAP or by asking your health librarian.

Youth Mental Health report 2014

Mission Australia in conjunction with the Black Dog Institute has reported that one in five young Australians are experiencing mental illness, with less than 40% of them feeling comfortable in seeking professional help.

The Youth Mental Health Report 2014 surveyed almost 15,000 15-19 year olds across Australia and found that females and Aboriginal respondents were far more likely to be experiencing mental illness.  These people showed a high concern about depression, suicide, bullying and family conflict. The report recommends various measures such as awareness programs in schools, peer education, reducing the stigma of mental illness and a focus on prevention and early intervention.

Mortality from asthma and COPD in Australia

Asthma death rates in Australia are high compared with many other countries and chronic obstructive pulmonary disease (COPD) is a leading cause of deaths in Australia and internationally. This report by the Australian Institute of Health and Welfare provides current information about mortality due to these conditions in Australia, examining trends over time, seasonal variation, international comparison and variation by age, sex, remoteness, Indigenous status, country of birth and socioeconomic disadvantage.

Click here to view the full report.                     

Prostate Cancer Breakthrough

The Trans-Tasman Radiation Oncology Group has conducted a five year trial, with the results published in the Lancet Oncology journal. The trial involved the Hunter Medical Research Institute, the University of Newcastle and the Calvary Mater. More than 1,000 men were involved, with doctors using testosterone suppression therapy, radiotherapy as well as a different type of anti-cancer drug. The combination therapy reduced the spread of aggressive, localised tumours by more than 40 per cent.

Denham et al., (2014). Short-term androgen suppression and radiotherapy versus intermediate-term androgen suppression and radiotherapy, with or without zoledronic acid, in men with locally advanced prostate cancer (TROG 03.04 RADAR): an open-label, randomised, phase 3 factorial trial. The Lancet Oncology, Early Online Publication, 15 August 2014. doi:10.1016/S1470-2045(14)70328-6

You will need to contact your library to access the complete article.

Guidelines for the management of overweight and obesity in adults

This special issue of the journal Obesity, has provided the Guidelines (2013) for Managing Overweight and Obesity in Adults as open access. The Executive Summary of the Guideline is copublished in three journals: Obesity, Circulation, and the Journal of the American College of Cardiology.

(2014). Executive summary: Guidelines (2013) for the management of overweight and obesity in adults. Obesity,  22(S2), S5-39

Ebola Haemorrhagic Fever

The Centers for Disease Control and Prevention (CDC) is regularly updating it's pages on Ebola, with information on transmission, signs and symptoms, and guidelines for air transport and gowning up. This government run organisation in Washington would be one of the best sources of reliable information.

Palliative radiotherapy at the end of life: A critical review

This article in CA: A Cancer Journal for Clinicians, discusses that when radiotherapy is delivered with palliative intent, it can help to alleviate a multitude of symptoms related to advanced cancer. It "explores the recent studies of radiotherapy near the end of life, examines general prognostic models for patients with advanced cancer, and describes specific clinical circumstances when radiotherapy may and may not be beneficial, and addresses open questions for future research to help clarify when palliative radiotherapy may be effective near the end of life".

Jones, J. A., Lutz, S. T., Chow, E. and Johnstone, P. A. (2014), Palliative radiotherapy at the end of life: A critical review. CA: A Cancer Journal for Clinicians. doi: 10.3322/caac.21242

Supporting people with coronary heart disease and depression

The Mental Health Professionals' Network (MHPN) in collaboration with the Heart Foundation, has produced an education webinar, "A collaborative approach to supporting people with coronary heart disease and depression."  

CPD points can be obtained by watching the webinar, which goes for approximately 67 minutes.  It follows the case study of an older woman, Sheila, who is experiencing psychological distress following a history of cardiac problems.  An interdisciplinary panel discusses the options available in supporting both Sheila's mental health and physical needs.

Working with older people with multiple long-term conditions

This qualitative study from New Zealand was published in The Journal of Advanced Nursing recently.  It aimed to gain an insight into how nurses work with this patient group and adopt a navigation role with them in the context of primary health care.  Interviews with nurses illustrated that while they lacked a complete understanding of the concept of patient navigation, the nurses were adopting many elements of professional navigation models.

"Working with older people with multiple long-term conditions: A qualitative exploration of nurses’ experiences".  Waterworth S, Gott M, Raphael D, Parsons J, Arroll B. Journal of Advanced Nursing, DOI: 10.1111/jan.12474 (2014).  The full text is available from CIAP or by contacting your health librarian.

Efficacy of paracetamol for acute low back pain

A study published recently in The Lancet indicating that paracetamol may not be effective in treating back pain has resulted in a good deal of media interest.  The authors concluded that "regular or as-needed dosing with paracetamol does not affect recovery time compared with placebo in low-back pain, and [we] question the universal endorsement of paracetamol in this patient group."

Two of the Australian authors, Christopher Williams and Jane Latimer, published a reader-friendly summary of their findings in The Conversation,  Put down the paracetamol, it's just a placebo for low back pain, and you can also find a handy precis by Norman Swan on the ABC news website.

The Lancet article, "Efficacy of paracetamol for acute low-back pain: a double-blind, randomised controlled trial" can be obtained in fulltext from the CIAP website, or by contacting your health librarian.  The Lancet, Early Online Publication, 24 July 2014 doi:10.1016/S0140-6736(14)60805-9

Patient and doctor shared decision-making

Doctors and patients sharing the decisions about medical conditions appears on fact value to be a sensible way of dealing with a person's health.  However, David Meltzer, Chief of Hospital Medicine at the University of Chicago, argues that this approach, depending on the doctors' incentives and the knowledge of the patient, can often lead to increased costs.

In this interview with Norman Swan on ABC Radio National's Health Report, Dr Meltzer says that shared decision-making is a very positive practice in terms of health outcomes, but not in terms of health costs because patients are more likely to want more procedures and to stay longer in hospital.  Meltzer also discusses more cost-efficient use of multidisciplinary teams in hospitals.

Radiation oncology areas of need

Radiation oncology areas of need: cancer incidence projections 2014-2024 is a report from the Australian Institute of Health and Welfare, which presents cancer incidence projections for 2014 to 2024. The projections were developed specifically for Australian Government Department of Health planning purposes and estimate that cancer incidence is likely to rise due to both an increase in cancer rates and in the numbers of Australians over 65. 

In 2024, an estimated 169,648 new cases of cancer are expected to be diagnosed in Australia, an average annual increase of 3.3% per year from 2010.  The largest increase is expected in Western Australia (5.0% per year), followed by the Australian Capital Territory (4.4%).  South Australia (1.9%) is expected to have the smallest annual proportional increase in cancer incidence rates.

Overview of Australian Indigenous health status

The "Overview of Australian Indigenous health status 2013" has been released and is now freely available on the Australian Indigenous HealthInfoNet website.  
This Overview of Australian Indigenous health status provides information about: Aboriginal and Torres Strait Islander populations; the context of Indigenous health; various measures of population health status; selected health conditions; and health risk and protective factors.

Australian Indigenous HealthInfoNet (2014). Overview of Australian Indigenous health status, 2013.

Health and the Primary Prevention of Violence against Women

The Australian Women's Health Network recently published a paper titled "Health and the Primary Prevention of Violence against Women".
Every week in Australia at least one woman is killed by her current or former partner, and since the age of 15, one in three women has experienced physical violence and one in five has experienced sexual violence. "This position paper focuses on the primary prevention of violence perpetrated by men against women. It develops a position on primary prevention (as distinct from secondary and tertiary interventions). It also identifies examples of good practice across settings, and factors for success for primary prevention programs. The paper has been developed as a resource for public education, debate and community activities related to the primary prevention of violence against women."
Click here to download the paper and others by the Australian Women's Health Network.

Working with families whose child is bullying

The Australian Institute of Family Studies has published a guide aimed at providing practitioners and other professionals with information on school bullying and ways to work with and support families with a child who is bullying others.

Working with families whose child is bullying: An evidence-based guide for practitioners.  

Eczema management guideline

The Royal Children's Hospital Melbourne clinical guideline on eczema management not only gives the management and treatment tools, but lists resources for treatment plans and extra resources for parents.

Eczema Management Clinical Guideline                               

Forum on Metastasis

The most recent issue of Cancer Forum, which is the official journal of the Clinical Oncology Society of Australia, includes a number of papers on Metastasis. This Forum marks the formation of the Australasian Chapter of the International Metastasis Research Society - OzMRS.

You can read all the articles freely online.

2014. Cancer Forum,  Vol 38 (2) Metastasis

Wellbeing for Indigenous Australians

Determinants of wellbeing for Indigenous Australians examines the wellbeing of Indigenous Australians and factors that may contribute to this. The focus is on subjective wellbeing but a number of objective measures of wellbeing are also considered. Compared with non-Indigenous Australians, Indigenous people tended to report lower levels of emotional wellbeing but they were more likely to say that they were satisfied with life.When Indigenous (and non-Indigenous) people reported that their health had improved, they also tended to report a rise in happiness and life satisfaction.

AIHW catalogue number (IHW 137).

 Download full report for free online. 

Asthma Inhaler Technique

A new survey highlighting that up to 90% of Australians with asthma don’t use their inhaler correctly has prompted NPS MedicineWise and Asthma Australia to jointly develop an online tool to help health professionals to assist their patients.

Asthma Australia CEO Mark Brooke says “Regardless of the type of inhaler device prescribed, people with asthma are unlikely to use their inhalers correctly unless they’ve received clear instruction, including a demonstration, and they have their inhaler technique checked regularly.”
Health Professionals can gain CPD points for completing the activity.

Unlocking asthma inhaler technique

Health outcomes for infants and young children

This report from the National Health Performance Authority (NHPA) shows how some organisations have broken with tradition when it comes to maternal and child health outcomes. In the past, regional and remote areas and areas of lower socio-economic level would normally have a lower rate of antenatal visits, maternal health and child health. However these latest statistics show that a number of Medicare Locals are making a difference, and they have been successful in tailoring primary healthcare to the needs of their regions. And the result is positive. The report also shows  areas which can do better in the future.

Child and Maternal Health in 2009-2012   

Clinical Practice Guideline for Acute Kidney Injury

This summary guideline is an adaptation of the KDIGO (Kidney Disease Improving Global Outcomes) Clinical Practice Guideline for Acute Kidney Injury. The summary includes a brief description of the adaptation methodology by Kidney Health Australia, and the adapted recommendations and suggestions for each subtopic. The complete KHA-CARI adapted guideline can be accessed at the KHA-CARI website (http://www.cari.org.au).

You can access the summary guideline here for free.
Langham, R. G., Bellomo, R., D' Intini, V., Endre, Z., Hickey, B. B., McGuinness, S., Phoon, R. K. S., Salamon, K., Woods, J. and Gallagher, M. P. (2014), KHA-CARI guideline: KHA-CARI adaptation of the KDIGO Clinical Practice Guideline for Acute Kidney Injury. Nephrology, 19: 261–265.