Population health guide to behavioural risk factors

Smoking, nutrition, alcohol, physical activity (SNAP): A population health guide to behavioural risk factors in general practice is a guide published by the Royal Australian College of General Practitioners,designed to assist general practitioners to work with patients on these specific lifestyle risk factors. It's also intended for organisations working with general practices, such as public health services.

The guide applies the "5 A's" to each risk factor: Ask, Assess, Advise, Assist, and Arrange support and includes evidence-based resources, planning and organisation for practices.

2nd ed. 2015. Melbourne: The Royal Australian College of General Practitioners. ISBN 978-0-86906-4269. 

Use of aged care services before death

This report from the Australian Institute of Health and Welfare examines people’s use of aged care services in the 8 years before death, using the cohort of 116,481 people who died in 2010–11 aged at least 65.  While some of these people used aged care services only in the year before death, others had accessed services over several years. 

The average age at death of this cohort was 85.2 for women and 81.5 for men. Overall, 80% had used aged care in the 8 years before death.  Almost half (47%) began using aged care more than 4 years before death. The older a person was when they died, the more likely they were to have been accessing a care program at the time of death and around 10% stopped using aged care in the last quarter before death. People used a diversity of care pathways. Around 80% of these people began by using HACC or VHC. Permanent RAC was the first service used for about half of the remainder.  

Use of Aged Care Services Before Death.  Data linkage series no. 19. Cat. no. CSI 21.

Best Practice in Statistical Reporting

The British Journal of Pharmacology has published a freely available virtual issue titled  Best Practice in Statistical Reporting.

You can read the collection of articles here on open access.

British Journal of Clinical Pharmacology- free virtual issues

The British Journal of Clinical Pharmacology has published a number of free virtual issues including:

•  Paediatric Prescribing
•  Future of Antimicrobials   

Acute hospitals and integrated care: From hospitals to health systems

In the UK, the NHS’ five year forward view envisages a change in the role of acute hospitals. In this report from the King’s Fund five case studies where acute hospitals are working collaboratively with local partners to build integrated models of care are discussed. In this vision, hospital leaders are taking a shared responsibility for leadership of a local system and this necessitates a system-wide perspective and working closely with primary care, community services, social care and others.

Acute hospitals and integrated care: From hospitals to health systems. (download the report for free) 

Not now, not ever: putting an end to domestic and family violence in Queensland

This report looks at the nature of domestic and family violence in Queensland. In 2013-14, there were 66,016 occurrences of domestic and family violence reported to Queensland police, which equates to over 180 incidents of domestic and family violence being reported every day across the state. 17 homicides relating to domestic and family violence occurred in Queensland in 2012-13. On average, across Australia, one woman is killed by her partner every week. The annual cost of domestic and family violence to the Queensland economy is estimated to be between $2.7 billion to $3.2 billion. 

This is the final report of The Taskforce on Domestic and Family Violence in Queensland, chaired by the Honourable Quentin Bryce AD CVO, former Governor-General of Australia. The Taskforce was established on 10 September 2014.  The Taskforce was requested to examine Queensland’s domestic and family violence support systems and make recommendations to the Premier on how the system could be improved and future incidents of domestic violence could be prevented.

‘Not Now, Not Ever’ – Putting an End to Domestic and Family Violence in Queensland.

Eight hours is enough- more sleep could lead to an early grave

Sleep is vital for good health but more of it may not always be better for everyone. Research recently published in the journal Neurology has found middle-aged and older people who sleep more than eight hours a day have an increased risk of stroke.  The findings are presented alongside a meta-analysis of 11 other studies from across seven countries involving over half a million people, which also finds longer sleeps can land you in an early grave.

Last month, the US-based National Sleep Foundation published revised guidelines on how much sleep people need based on input from 18 sleep experts and over 300 studies. For those aged between 18 and 65 years, it recommended between seven and nine hours over a 24-hour period. For those aged over 65, it suggested the narrower band of between seven and eight hours. In the light of the new findings, this narrower band may be the best idea for all adults, not just those aged over 65 years.

Read the summary article, "Eight hours is enough – more sleep could lead to an early grave", by Dorothy Bruck on The Conversation web page.

Cardiovascular disease, diabetes and chronic kidney disease-Australian facts: risk factors

This report is a series of 5 reports by the National Centre for Monitoring Vascular Diseases at the Australian Institute of Health and Welfare that describe the combined burden of cardiovascular disease (CVD), diabetes and chronic kidney disease (CKD).

This report on risk factors presents the latest statistics on the behaviours and characteristics that increase the likelihood of a person developing these chronic diseases. It also describes risk factors among people who already have CVD, diabetes or CKD. It examines age and sex characteristics and variations across population groups, including by geographical location and socioeconomic disadvantage.

Cardiovascular disease, diabetes and chronic kidney disease—Australian facts: risk factors, ISBN 978-1-74249-692-4; Cat. no. CDK 004  (free to download)             

Clinical practice guidance for management of pre-eclampsia

Pre-eclampsia (PE) is a leading cause of maternal and fetal/neonatal morbidity and mortality worldwide. An opinion article by Holger Stepan et al. explores the changing approaches to the diagnosis of pre-eclampsia and provides a consensus statement for the application of the sFlt1/PIGF ratio for the prediction, diagnosis and now also management of this condition, which could improve clinical care. This article is open access.

Stepan, H. [et al] (2015) Implementation of the sFlt-1/PlGF ratio for prediction and diagnosis of pre-eclampsia in singleton pregnancy: implications for clinical practice. Ultrasound in Obstetrics and Gynecology, 45(3), 241-246              

Incentives to follow Best Practice in Health Care

This briefing by the Office of Health Economics (UK) aims to review the evidence on the effectiveness of incentives to follow best practice health care, describe the incentives currently in place in the UK, and to determine if additional or modified incentives are required to promote adherence to best practice care. The scope is both primary and acute care, and both financial and non-financial incentives are examined.

Strong evidence exists for the provision of timely and meaningful information on safety and quality performance to clinical teams, particularly if this is benchmarked against the performance of peer teams or institutions.  

Incentives to Follow Best Practice in Health Care. Office of Health Economics; Briefing 55

Osteoporosis and juvenile arthritis web pages

These web pages present the latest available data from the AIHW National Centre for Monitoring of Arthritis and other Musculoskeletal Conditions. The release includes a landing page for each condition with high level summary information and links to supporting pages with information on prevalence, treatment, management, quality of life and expenditure.

AIHW Osteoporosis and juvenile arthritis web pages.

Watering the Garden of Family Wellbeing: Empowering Aboriginal and Torres Strait Islander people to bloom and grow

Family Wellbeing is an effective social and emotional well being program originally developed and delivered by and for Aboriginal people. The central objective of Family Wellbeing (FWB) is to develop people’s skills and capacity to move from a position of disempowerment to empowerment. FWB aims to empower Aboriginal and Torres Strait Islander people with a way to control and change their lives.
Recommendations and outcomes from the national roundtable Empowering Aboriginal and Torres Strait Islander people through the Family Wellbeing program, Adelaide, March 2014 have recently been published as Watering the Garden of Family Wellbeing: Empowering Aboriginal and Torres Strait Islander people to bloom and grow. 

This publication is free to download.  

Support for nurses in writing for publication

Writing for publication is essential for the dissemination of knowledge and practice, but many health practitioners are prevented from writing by a lack of confidence or knowledge of what the process involves, and insufficient time and space in which to write. This article discusses the importance of supporting nurses to write for publication and the approach used to do this, including: 

• How nurses can gain confidence to write
• Learning writing skills and finding time to write
• Setting goals and taking part in writing support groups

Williams B. (2015) Support nurses in writing for publication. Nursing Times; 111: 9, 15-17, 2015. 

Putting On and Removing Personal Protective Equipment - video

Personal protective equipment is used when there is a risk of exposure to infectious material, to protect the skin and mucous membranes from exposure to pathogens. In light of the threat of Ebola virus disease, it is important to emphasize the use of proper precautions for infection control in health care settings.This video is part of "Videos in Clinical Medicine" on the NEJM site and demonstrates how to put on and how to remove PPE. It is freely available.

Putting On and Removing Personal Protective Equipment. Rafael Ortega, M.D., Nahid Bhadelia, M.D., Osamede Obanor, B.S., Kyle Cyr, M.A., Priscilla Yu, B.A., Maureen McMahon, R.N., and Dahlia Gotzmann, B.S.N. N Engl J Med 2015

Admitted patient care 2013-14

Admitted patient care 2013-14: Australian hospital statistics has been published by the Australian Institute of Health and Welfare. It presents a detailed overview of admitted patient activity in Australia's public and private hospitals. In 2013-14, there were about 9.7 million separations from hospitals, including:

• 5.5 million same-day acute care separations
• 3.8 million overnight acute care separations
• about 460,000 sub-acute and non-acute care separations.

Download the complete report for free.

AIHWcatalogue number (HSE 156).                                                                      

Asthma Snapshot

The Australian Institute of Health and Welfare has published a  snapshot of the latest statistics on asthma in Australia. This is a web-based product providing the latest available information about this health condition in Australia. Asthma is a common condition, affecting 1 in 10 Australians and this snapshot provides information about prevalence, treatment, management, quality of life and expenditure.

Asthma Snapshot

Death and life expectancy in Australia - snapshot

The Australian Institute of Health and Welfare has released an update on its Deaths Web Snapshot today. This presents the latest data on deaths, causes of death and life expectancy in Australia. 

There were 147,678 deaths registered in Australia in 2013. Two-thirds (66%) of deaths were among people aged over 75 years. Over the period 1907 to 2013, the age-standardised death rates fell by 74%. Chronic diseases, such as cardiovascular disease, dementia and cancers, continue to be the leading cause of death in the overall population, however younger people tend to die from external causes such as transport accidents and suicides. Australia has one of the highest life expectancies in the world, at 84.3 years for females and 80.1 years for males born in 2011-2013. 

Multidisciplinary teams and better health outcomes

A report conducted for Services for Australian Rural and Remote Allied Health (SARRAH) has revealed that Australians with stroke, diabetes and osteoarthritis could avoid surgery or recover more quickly if they had access to multidisciplinary teams of health professionals.

Investigating the Efficacy of Allied Health: Reducing Costs and Improving Outcomes in the Treatment of Diabetes, Osteoarthritis and Stroke found that common surgeries including hip and knee replacements and diabetic limb amputations could be avoided if patients were seen by allied health providers including physiotherapists, dietitians and podiatrists.

Asthma and COPD medications chart

The National Asthma Council Australia has provided this useful education resource for general practitioners, pharmacists, respiratory physicians, asthma educators, allergists and practice nurses. The Asthma and COPD medications chart is guide to the main types of asthma and COPD medications available in Australia and has been updated this month.

Copies of the chart can be printed from the pdf provided, or you can order free printed copies from the site.

Cisplatin - 50th anniversary

It is 50 years since the accidental discovery that cisplatin could be used as an anti-cancer drug.  An article in The Conversation this week by Nial Wheate and Michael Apps from the University of Sydney, Happy 50th anniversary to cisplatin, the drug that changed cancer treatment, looks at the history of the drug and explains how it is still relevant in cancer treatment today. The authors also explain that cisplatin is improving in becoming more effective and less toxic.

Optimising return to work practices following catastrophic injury

And in another briefing paper from The National Trauma Research Institute, Optimising return to work practices following catastrophic injury, the aim was "to enhance understanding of the features of optimal return to work practices following traumatic brain and spinal cord injury and identify barriers and facilitators to their implementation."

Worldwide, mean return to work rates for people with catastrophic injury are approximately 30-40%, but in Australia this figure is unknown. Internationally, the best RTW rates reported for moderate to severe traumatic brain injury (TBI) come from the UK, Sweden and USA, whilst for spinal cord injury (SCI) they are in Switzerland and Sweden.

Interventions that have been identified to facilitate RTW for this group include program based rehabilitation, supported employment and case co-ordination. The questions that have been identified for future discussion are what barriers are there to optimising RTW outcomes in Australia and how can they be addressed.

Optimising support for informal carers of the long-term disabled

This briefing document from the National Trauma Research Institute at Monash University points out that optimising carer resilience has direct benefits to carers and additional benefits to the overall care support system by reducing dependence on paid care.  

Optimising support for informal carers of the long-term disabled to enhance resilience and sustainability reports that there are 2.7 million people in Australia providing unpaid care to a person with a disability or long-term health condition. A literature review aimed to investigate effective strategies for providing support to these informal carers that can help to optimise their resilience, and the sustainability of the long-term disabled.  

Access to mental health care in Australia

The largest ever study into mental health services in Australia has found that government programs are failing to give people in poor and remote areas equal access to help. Researchers from Monash University have recently published the results of their study on open access in the Medical Journal of Australia. 

Better access to mental health care and the failure of the Medicare principle of universality looked at Medicare data relating to 25 million mental health items billed between 2007 and 2011 and found that people who lived in disadvantaged parts of metropolitan areas and rural and remote areas accessed the least number of services despite needing them the most.

Graham N Meadows, Joanne C Enticott, Brett Inder, Grant M Russell and Roger Gurr
Med J Aust 2015; 202 (4): 190-194.  doi:10.5694/mja14.00330