Healthy life expectancy in Australia: patterns and trends 1998 to 2012

Australians can now expect to enjoy longer lives with more years free of disability, according to a report released by the Australian Institute of Health and Welfare (AIHW).

The report, Healthy life expectancy in Australia: patterns and trends 1998 to 2012, shows the gains in the number of expected years living free of disability were related to a combination of increasing longevity and decreases in disability prevalence rates.

Between 1998 and 2012, life expectancy at birth has risen by 4 years for boys and nearly 3 years for girls. And because disability prevalence rates have been falling over this period, the gain in disability-free life expectancy has been even greater for boys (4.4 years, compared with 2.4 years for girls). Older Australians have also seen increases in the expected number of healthy years, but this has been accompanied by more years needing assistance with everyday activities. 

Healthy life expectancy in Australia: patterns and trends 1998 to 2012.        

Safe and high-quality care for patients with cognitive impairment

The Australian Commission on Safety and Quality in Health Care has released three resources to guide health service managers, clinicians and consumers in improving care of people with cognitive impairment in hospital.

These resources were developed in recognition that cognitive impairment (dementia and delirium) is common among older people admitted to hospital and patients with cognitive impairment are at greater risk of preventable complications, and adverse outcomes, including falls, pressure injuries, functional decline and mortality. They are more likely to stay in hospital longer, be re-admitted or enter residential care.

The resources follow a pathway, describing strategies that reflect evidence-based practice and existing models of care. In the resource for health service managers, the strategies are linked to the existing National Safety and Quality Health Service (NSQHS) Standards.

The three resources are: 

• Action for health service managers
• Action  for clinicians
• Action for consumers

A better way to care: Safe and high-quality care for patients with cognitive impairment (dementia and delirium) in hospital. 2014           

Antimicrobial Stewardship Clinical Care Standard

Bacteria can develop resistance to specific antibiotics, meaning that the antibiotic is no longer effective against those bacteria. The inappropriate use of antibiotics has increased the development of antibiotic-resistant bacteria, not only in hospitals and healthcare facilities but also in the community. Antibiotic resistance poses a significant threat to public health because antibiotics underpin routine clinical practice in a variety of healthcare settings. 

The Australian Commission on Safety and Quality in Health Care, in collaboration with consumers, clinicians, researchers and health organisations, has developed the Antimicrobial Stewardship Clinical Care Standard and resources to guide and support its implementation.  

Chronic diseases in Australia: the case for changing course

This paper, written by Dr Sharon Willcox with the Mitchell Institute for Health and Education Policy and a national expert advisory group, provides the case for changing course in Australian policies. It addresses the health and non‐health factors contributing to the prevalence of chronic diseases and puts forward four major directions for change.

Chronic diseases in Australia: the case for changing course; Background and Policy Paper No. 02/2014

Headline Indicators for Children's Health

The Children's Headline Indicator dynamic data from AIHW provides the latest available information on how Australia's children aged 0-12 are faring according to 19 priority areas. These areas include health status, risk and protective factors, early learning and care, and family and community environments.

Indicators include: 

• Child abuse and neglect - updated (data for 2012-13 added)
• Early childhood education - updated (data for 2013 Indigenous status, Remoteness and socioeconomic status added)
• Immunisation - updated (data for the quarter ending 30 September 2013 added)
• Injuries - revised (rates recalculated using Estimates of Australia's resident population based on the 2011 Census)
• Teenage births - revised ('Total' birth rate and the disaggregation by Indigenous status rates have been recalculated using Estimates of Australia's resident population based on the 2011 Census).

Children's Headline Indicators, AIHW 2014

Integrating Care for Older People with Complex Health Needs

In 2010, there were 1.02 million people 65 years of age and over living in NSW, and this is expected to double by 2050. However, for a growing number of older people, this will include living with complex health needs such as dementia and other chronic diseases. Currently, care is fragmented between different healthcare providers in community, primary health and acute care settings.  

 The Building Partnerships Framework published by the Agency for Clinical Innovation, provides the most comprehensive look yet at how to integrate services for older people with complex health needs and introduces a vision of multi-sector partnerships that involve older people, their carer and families every step of the way. 

Framework for Integrating Care for Older People with Complex Health Needs 2014

The Impact of Depression At Work

An international study reveals Australians hide their depression at work more than employees in other countries, fearing misunderstanding, stigma, and discrimination. ‘Depression is biggest mental health challenge among people of working-age, and the leading cause of disability worldwide,’ explains Jack Heath, CEO of the national mental health charity, SANE Australia.

The Impact of Depression at Work: Australia Audit surveyed 1031 adults aged 16-64 Australia-wide. All workers, including a sub-sample of managers (32%), had worked within the previous 12 months.

SANE Research Bulletin 18 The Impact of depression at work 

Journal of Compassionate Health Care

This new journal aims to provide a vehicle for bringing together multidisciplinary perspectives, research and initiatives concerning the concept of compassionate health care. Compassion may also be viewed as a vehicle for enhancing quality and reducing the cost of health care services.
Some of the subjects covered in this very first open access issue include:

• Compassion meditation intervention for people with chronic pain.
• Patient centred care retreats.
• Re-inspiring compassionate caring.

Journal of Compassionate Health Care 2014, 1                     

Health promotion in Aboriginal and Torres Strait Islander communities

A special edition of the Australian Journal of Primary Health focuses on Health Promotion in Aboriginal and Torres Strait Islander Communities.  Authors Kerry Arabena, Kevin Rowley and Sarah MacLean look at these communities and the importance of family and the natural world.   They discuss building capacity within their organisations and changing the way mainstream communities interact with Aboriginal and Torres Strait Islander peoples. A clear message is that for too long Aboriginal and Torres Strait Islander people have been described as having problems that are too big and complex to be solved within communities themselves bu now we are changing the collective story from one of deficit, to one of strength and resilience.

Contact your health library if you have trouble accessing the full text.

Australian Journal of Primary Health Special Issue, Volume 20, Number 4.

Medicine list smartphone app

NPS MedicineWise have developed a free app for an iPhone or Android smartphone, where patients can store a list of their medications.

MedicineList+ allows people to keep all the information about their medicines in one place, and includes alarms and reminders about when to take medicine. It's a handy tool to help prevent medication error, and easily reviewed by health professionals generally, and in an emergency.

NICE evidence updates

The National Institute for Health and Care Excellence (NICE) in the UK, regularly publish Evidence Updates on their website, which summarise new evidence on various clinical subjects, highlighting key points and commenting on the strengths and weaknesses of the new and old evidence.

The latest update is on Headaches which updates their guideline CG150 ‘Headaches: Diagnosis and management of headaches in young people and adults’ with selected new evidence.  New topics coming soon include lower limb peripheral arterial disease and psoriasis - both due in mid November. Topics are searchable by specialty or by date, and you can subscribe on the site for email updates.

Taking a best possible medication history

Get it right! Taking a best possible medication history is an online learning module aimed at junior medical officers, nursing and pharmacy staff for admitting patients to hospital.  Obtaining an accurate medication history (known as a best possible medication history or BPMH, is the first step in the medication reconciliation process and helps with making therapeutic decisions.

The module includes a video which explains what information should be recorded and how certain techniques can influence the accuracy of the history obtained.  There is al a short role-play scenario and some useful tips. Nurses and pharmacists can earn professional development points by completing the module, which was developed by the Australian Commission on Safety and Quality in Health Care and NPS MedicineWise. You will need to complete a free registration process before you get started.

Arthritis and disability

Arthritis and Disability is a report on the lived experience of people with arthritis and similar conditions.  It was commissioned by Arthritis Australia and outlines the methods, findings and implications of this research, carried out by the Social Policy Research Centre at the University of New South Wales.

Arthritis is the second leading cause of disability and the most common cause of chronic pain in Australia, and the most prevalent long-term health condition, affecting 3 million people or about 15 per cent of the population. This work looks at the extent to which arthritis is associated with disability–who is affected, how people are affected, what helps people cope with their condition day to day, and how support services can be improved.

Australia's falling birth rate

The Australian Bureau of Statistics has released new birth rate figures, showing that this country's birth rate is the lowest since 2006.  Births, Australia, 2013 indicates that Australia's total fertility rate fell from 1.93 in 2012 to 1.88 in 2013.  Conversely, the trend among older mothers, between 40 and 44 years, has shown increased fertility since the mid 1970's, almost tripling in the last 30 years.

Cardiovascular disease, diabetes and chronic kidney disease mortality

This AIHW report describes deaths in the Australian population as a result of three chronic conditions, singly or in combination. Cardiovascular disease, diabetes and chronic kidney disease: Australian facts: mortality reports that in 2011, these three diseases together were the underlying cause of almost 53,000 deaths - 36% of all deaths.  Overall 61% of all deaths had at least one of these diseases recorded as an underlying or associated cause of death. CVD was the underlying cause of 45,622 deaths, 31% of all deaths. CHD accounted for 47% of CVD deaths, followed by stroke (19%). CVD contributed to 56% of all deaths.

The CVD mortality rate has declined significantly since 1981, while the diabetes rate has remained unchanged, and CKD mortality has been stable since 2000. In 2011, the rates of all these diseases were higher in males, older people and people in lower socioeconomic groups.

Healthy eating guidelines for metabolic and endocrine diseases

The American Association of Clinical Endocrinologists has released a new guideline, Clinical practice guidelines for healthy eating for the prevention and treatment of metabolic and endocrine diseases in adults.  The Guideline, cosponsored with the American College of Endocrinology and the Obesity Society, targets adults with or at risk of metabolic and endocrine diseases and considers morbidity, mortality, obesity, pregnancy issues, elderly care and malnourishment in making very specific dietary recommendations.

Palliative care factsheets for patients and carers

CareSearch Palliative Care Knowledge Network has just released a new feature on their website called My Information Kit.  This site allows health professionals to select relevant factsheets which have been compiled by CareSearch, the Australian Centre for Grief and Bereavement, Palliative Care Australia and Carers NSW, for printing or emailing to patients and carers. There is provision for a cover sheet to be attached including your name and contact details.

The factsheets cover a range of issues including bereavement, support and wellbeing for carers, pain, communication and living with a terminal illness.

Australian hospital statistics 2013–14: emergency department care

This report from the Australian Institute of Health and Welfare reveals that there were over 19,700 presentations per day in public hospital emergency departments in 2013-14 - an increase of 7.2% from the previous year.  75% of patients were "seen on time", with NSW hospitals performing best at 81%.  Nationally, the proportion of emergency department visits complete in 4 hours or less increased from 64% to 73% since the last report.  In NSW that figure increased from 60% to 74% over the past two years.  29% of emergency department patients were admitted to hospital after their ED care.

For these and many other interesting statistics, broken down to State level, access the full report. AIHW 2014. Australian hospital statistics 2013–14: emergency department care. Health services series no. 58. Cat. no. HSE 153. Canberra: AIHW.

Sense of smell and mortality

Being unable to smell in older adults could be a predictor of increased risk of death within five years. In a study of more than 3,000 people aged 57 to 85, 39 per cent of subjects who failed a simple smelling test died within five years, according to results published in the journal PLOS One.
"Compared to a person with a normal sense of smell, a person with an absent sense of smell has three times greater risk of dying within a five-year span," says the study's lead author Dr Jayant Pinto of the University of Chicago. If one's sense of smell is in decline, it could be a warning for your GP to look further.

Pinto, Jayant M. [et al] (2014). Olfactory Dysfunction Predicts 5-Year Mortality in Older Adults. Plos One. DOI: 10.1371/journal.pone.0107541

Guideline for the treatment of juvenile idiopathic arthritis

There has been an update of the 2011 American College of Rheumatology recommendations for the treatment of juvenile idiopathic arthritis: recommendations for the medical therapy of children with systemic juvenile idiopathic arthritis and tuberculosis screening among children receiving biologic medications. The guideline summary is available on the National Guideline Clearinghouse site.

 Update of the 2011 American College of Rheumatology Recommendations for the Treatment of Juvenile Idiopathic Arthritis. (2013), Arthritis and Rheumatism. Vol. 65, No. 10, October 2013, pp 2499–2512 DOI 10.1002/art.38092