Can I trust the findings of this health research?

Health professionals and consumers alike can sometimes be confused about what constitutes reliable versus unreliable health research. What do we believe, and how can we tell?

This tool from the Medical Research Council in the UK and the University of Glasgow is a very useful way to help you assess the merits of particular studies. It guides you through a series of questions to ask about what you're looking at, and at the end you receive a summary of your answers and what they mean - which should help you to decide how reliable the conclusions really are.

Understanding Health Research: A tool for making sense of health studies

Illegal drug use and possession

The NSW Parliamentary Research Service has produced a briefing paper: Illegal drug use and possession: current policy and debates.  Among the current debates discussed here is the decriminalisation of recreational drug use, illegal drug use at music festivals and the possibility of medically supervised smoke inhalation rooms for ice users.

The paper provides information on the rates of illegal drug use, its harms, and the current policies and laws in Australia surrounding illegal drug use.

Tom Gotsis, Chris Angus, Lenny Roth, Parliament of NSW.

Mapping the Indigenous Program and Funding Maze

There is a lot of goodwill in Australia to improve indigenous outcomes, however, too many programs are implemented because of their perceived benefit, rather than a rigorous assessment of what works.
This research report maps the number of government and non-government Indigenous programs and potential level of duplication among different program providers (federal, state/territory and non-government). The report also estimates how much funding is allocated for Indigenous specific programs, across the non-government sector as well as by federal and state/territory governments.

Hudson, Sara. (2016). Mapping the Indigenous Program and Funding Maze. Centre for Independent Studies. CIS research report ; 18

COPD, Associated Comorbidities and Risk Factors

 AIHW has published a new web report on COPD and Comordibities. People with COPD often have other chronic diseases and long-term conditions. These are referred to as 'comorbidities'—two or more health problems that are present at the same time. Comorbidities are typically more common in older age groups.

The chronic conditions selected for this AIHW analysis include asthma, cardiovascular disease, back problems, mental health problems, arthritis, diabetes and cancer. They were selected because they are common in the general population and cause significant burden. Australians with COPD currently have at least one other chronic condition (91%), based on self-reported data.

COPD, associated comorbidities and risk factors. AIHW 2016 

Daily Iron Supplementation in Infants and Children: WHO Guideline

Where anaemia is highly prevalent, iron supplementation is recommended from 6 months. Daily oral iron supplementation is a preventive strategy for implementation and recommended as a public health intervention.This guideline has been published by the WHO Department of Nutrition for Health and Development. WHO also hosts the Vitamin and Mineral Nutrition Information System (VMNIS)  micronutrients database.

WHO guideline: daily iron supplementation in infants and children, World Health Organisation. NGC:010942. 2016             

Social Work Leadership and Management

The Australian Association of Social Workers’ (AASW) Scope of Social Work Practice series provides an overview of the role, scope and contribution of social work practice. This document on leadership highlights the crucial role and services that social workers provide and that employers and clients can expect. Social workers, policy makers, managers and academics can use this scope of practice to articulate and promote the role of professional social workers in this field.

Scope of Social Work Practice: Leadership and Management. Australian Association of Social Workers. 2016

Autism Spectrum Disorder in Adults

A significant proportion of adults with autism across the whole autistic spectrum experience social and economic exclusion. Their condition is often overlooked by healthcare, education and social care professionals, which creates barriers to accessing the support and services they need to live independently. In addition, people with autism are more likely to have coexisting mental and physical disorders, and other developmental disorders.
This guideline from the National Institute for Health and Care Excellence (NICE) on autism in adults has recently been updated. The guideline covers the care provided by primary, community, secondary, tertiary and other health and social care professionals who have direct contact with, and make decisions concerning the care of, adults with autism.

Autism spectrum disorder in adults: diagnosis and management. NICE Guidelines CG142

Medical workforce in Australia 2015

Australia's Medical Workforce 2015 has just been published as a web report by the AIHW.  It looks at the demographic and employment characteristics of medical practitioners registered in Australia from 2005-2015. Some of the statistics include:

• The total number of registered medical practitioners increased from 67,890 in 2005 to 97,466 in 2015. 
• The supply of general practitioners changed very little between 2005 and 2015 per head of population
• There has been no increase in the supply of hospital non-specialists in the last five years, but the supply of non-GP specialists increased, and so did the supply of specialists-in-training

"This suggests that while the supply of GPs and non-specialists is keeping pace with population growth, the number of medical practitioners working in, or training to take on, roles in other specialties is growing faster."

Predicting success in medical school

Research from South Australia examined the predictive value of the three most common tools used to select students for Medical courses:  previous academic performance, cognitive aptitude and non-academic qualities (assessed in an interview). A four-year retrospective cohort study revealed that previous academic performance was the most consistent predictor of future performance.


The authors of the study published in BMC Medical Education concluded that "The continued use of multiple selection criteria to graduate entry medical courses is supported, with GPA remaining the single most consistent predictor of performance across all years of the course. The national admissions test is more valuable in the pre-clinical years, and the interview in the clinical years."
 
Ruth Sladek, Malcolm Bond, Linda Frost, Kirsty Prior. Predicting success in medical school: A longitudinal study of common Australian student selection tools BMC Medical Education, 16, 187 dx.doi.org/10.1186/s12909-016-0692-3

OECD health care quality indicators for Australia

OECD health-care quality indicators for Australia 2015 has recently been released by the Australian Institute of Health & Welfare. The report compares data supplied by Australia to the OECD in 2015 to previous years and to other OECD countries.  Categories for indicator comparison are avoidable hospital separations, acute care, cancer care, patient safety and patient experience.  Areas where Australia performed above average included hypertension hospital separations, acute myocardial infarction mortality and postoperative pulmonary embolism rates. Areas where Australia performed below average included COPD hospital separations and postoperative sepsis rates.

 

Impacts of Chronic Back Problems

 An estimated 3.7 million Australians or 1 in 6 people had chronic back problems in 2014–15, according to a report released by the Australian Institute for Health and Welfare (AIHW). The problem can have a strong negative effect on a person's quality of life, affecting their ability to participate in daily activities, work, family and social activities. 

The report also shows that 28% of people with a disability (around 1.2 million people) also had a chronic back problem.

 This bulletin provides the latest detailed information on the impacts (in terms of quality of life and disability) of chronic back problems in Australia.

2016. Impacts of chronic back problems. AIHW bulletin no. 137. Cat. no. AUS 204. Canberra: AIHW.   

Understanding Health Research and Dr Google

Scientists in the UK have come up with a new online tool that helps you make sense of health studies. Understanding Health Research is a free website that lets people assess the quality of research papers they stumble across.  Trying to read health research on our own also leads into the often dangerous territory of relying on Dr Google. With plenty of research papers available online either via open access from publishers, or via a quick search for the PDF on Google Scholar, the free online tool provides a step-by-step process anyone can use to inform their judgement on the study. For example, if you feel sceptical about the latest newspaper story on a new breakthrough in heart disease treatment, you can grab a copy of the paper and have a look through it under the guidance of the questions posed by the website.
Understanding Health Research: A tool for making sense of health studies.

Australian Work Exposures Study - Asthmagens

Recent research shows 47% of male and 40% of female workers were exposed to one or more asthmagens in their workplace. The Extended Australian Work Exposure Study (AWES–2) examined the types of work and workers most likely to be exposed to asthmagens (substances that cause asthma) in their workplace. The study also found that workers could be exposed to more than one asthmagen depending on the types of tasks undertaken at work.

This summary from Safe Work Australia, describes the results of a national, population-based survey of Australian workers to examine the prevalence of exposures to asthmagens at work.

A full description of the methodology and findings of this study was published in the peer-reviewed paper "The estimated prevalence of exposure to asthmagens in the Australian workforce, 2014." The article in BMC Pulmonary Medicine is open access.  

The Lazarus Phenomenon

The Lazarus phenomenon or the unassisted return of spontaneous circulation after cardiac arrest is a largely underreported phenomenon in medical literature which essentially implies the ‘resurrection’ of an individual after cardiac arrest.
 Because of the presumed infrequency of this condition, there are no studies specifically researching Lazarus phenomenon in scientific literature. This review intends to systematically present current and past knowledge on this rare phenomenon.

Sahni, Vaibhav. (2016). The Lazarus Phenomenon. JRSM Open, 7(8) doi:0.1177/2054270416653523 

Hospital care for Aboriginal people

This edition of Patient Perspectives: Hospital Care for Aboriginal People provides an important opportunity to listen to what Aboriginal people have to say about their experiences in hospital. It explores whether there are differences in care provided to Aboriginal patients compared to non-Aboriginal patients. It also allows us to contrast performance across local health districts, examining whether Aboriginal patients’ perspectives differ according to location or geography; and identifying where patients report good, or poor, experiences of care.

Published by the Bureau of Health Information in August 2016, the report draws on data from almost 2,700 Aboriginal patients who were admitted to a NSW public hospital in 2014.

Fractures: Assessment and Management

NICE (National Institute for Health and Care Excellence) has developed four related clinical guidelines and one service delivery guideline related to the management of people with traumatic injuries including this guideline on complex fractures and the following guidelines:

• Fractures (non-complex): assessment and management
• Major trauma: assessment and initial management
• Major trauma: service delivery
• Spinal injury: assessment and initial management

The Nurses' Health Study

The Nurses' Health Study was formed in 1976 with 121,701 female registered nurses in the USA, originally to look at the relationship between the use of oral contraceptives and breast cancer.  Graham Colditz has published a paper in Public Health Research & Practice, which looks at how the study, still operating forty years later, has broadened its focus through biannual questionnaires, to include a much wider analysis.

Nurses’ health study: demonstrating the impact of research, and adapting new measures and approaches to increase relevance and effect of cohort studies looks both at this particular study, which now reports on a wide range of measures and their relationships to chronic disease, and also at the contribution of cohort studies as a methodology.  "The aim of this report is to highlight the features of the Nurses’ Health Study and other cohorts that demonstrate continuing contributions to the changing epidemiology of chronic conditions."


Public Health Res Pract. 2016;26(3):e2631628  DOI: doi.org/10.17061/phrp2631628             

Seven strategies for ending violence against children

Across the world up to one billion children have experienced physical, sexual or psychological violence in the past year.  The World Health Organization has published INSPIRE: seven strategies for ending violence against children as an evidence based resource aimed at government strategists, community groups, the private sector and health workers. 

The strategies selected have been shown to be effective in reducing violence against children.  They are categorised as:  Implementation and enforcement of laws; Norms and values; Safe environments; Parent and caregiver support; Income and economic strengthening; Response and support services; and Education and life skills. 

Understanding health research videos

The National Collaborating Centre for Methods and Tools (NCCMT) in Canada has published a series of twelve videos to support "evidence-informed public health".  These videos, each only 5 - 10 minutes long, explain some of the basic concepts you need to understand when looking at research evidence.  

Understanding Research Evidence includes: 

What’s the Risk? Understanding Absolute and Relative Risk Reduction   Making Sense of a Standardized Mean Difference Evidence Informed Decision Making Effectiveness of Interventions  6S Pyramid - a tool that helps you find evidence quickly and efficiently   Types of Reviews - What kind of review do we need   Relative Risk  Understanding what a P value tells us   Clinical Significance   Confidence Interval   Forest Plots - Understanding a Meta-Analysis in 5 Minutes or Less   Odds Ratios

Australia's Hospitals - three new reports

The Australian Institute of Health and Welfare has just released three new Australia's hospitals 2014-15 reports, as well as an at-a-glance online overview:

Australia's hospitals 2014-15 at a glance provides a summary of Australia's public and private hospitals.  During that year there were 10.2 million hospitalisations.  There were 7.4 million presentations to emergency departments in public hospitals, with 74% of patients seen within the recommended times for their triage category.

Hospital resources 2014-15: Australian hospital statistics gives a detailed overview of public and private hospital resources in Australia.  There were 698 public hospitals with over 60,000 beds and 624 private hospitals with almost 3000 beds in that year.

Non-admitted patient care 2014-15: Australian hospital statistics details that about 34.9 million non-admitted patient service events were provided in public hospitals. 46% of these events occurred in allied health or clinical nurse specialist clinics.

Australia's hospitals 2014-15 at a glance is an online overview of all three published reports. 

Newly mapped brain

Neuroscientists have recently reported on an analysis of the brains of 210 healthy young adults and mapped 180 areas of the brain in full colour.  This includes 97 regions of the outer layer of the brain that were previously undiscovered. The research team led by Matthew Glasser and co-funded by the US National Institutes of Health, used data from the Human Connectome Project and was published in the journal Nature.

Pankaj Sah from the University of Queensland penned a useful explanatory article about this research in The Conversation this week, Mapping the brain: scientists define 180 distinct regions, but what now?  He writes, "An updated brain atlas will provide greater insights into how the brain controls behaviour and how disorders in certain regions contribute to brain diseases."

Glasser, MF et al. A multi-modal parcellation of human cerebral cortex. Nature. 2016 Jul 20. doi: 10.1038/nature18933. [Epub ahead of print]

Australia's Health Tracker 2016

The Australian Health Policy Collaboration (at Victoria University) has launched Australia's Health Tracker 2016, a report card on preventable chronic diseases, conditions and their risk factors: tracking progress for a healthier Australia by 2025.  This is the first of a series of regular issues and there are also seperate report cards for Adult Health and Children and Young People's Health. Over 50 public health organisations and experts have contributed to this document. 

One in two Australians suffers from a chronic disease, a third of which could be prevented by removing exposure to risk factors such as smoking, high body mass, alcohol use, physical inactivity and high blood pressure.  The emphasis is to increase resources for preventive measures.

Diabetes among Aboriginal and Torres Strait Islander people

Published recently by The Australian Indigenous HealthInfoNet is a comprehensive Review of diabetes among Aboriginal and Torres Strait Islander people.  The review is aimed at informing people involved in Aboriginal and Torres Strait Islander health care and to provide evidence for policy makers. 

There have been varying reports about the extent of this problem, but in 2012-2013, national estimates of the prevalence of diabetes among Aboriginal and Torres Strait Islander people ranged from 9% (based on self-reported data) to 11% (based on biomedical data). "After age-adjustment, Aboriginal and Torres Strait Islander people were more than 3 times as likely as non-Indigenous people to have diabetes."  In addition, hospitalisation rates for complications of type 2 diabetes were almost six times higher than for non-Indigenous people.

As well as looking at the data for prevalence and complications, the review puts Aboriginal and Torres Strait Islander diabetes into context, discusses current prevention and management programs and policies and suggests future directions.

Poisoning in children and young people 2012-13

The Australian Institute of Health and Welfare has released a new report, Poisoning in children and young people 2012-13.  It reports on people aged 0-24 who were hospitalised due to poisoning in Australia, which was over 30% of all cases of poisoning.  49% of poisoned people under 24 were aged 18 and over, and 26% were aged 15-17.    

For all types of poisoning the rates were much higher for girls and young women than for boys and young men.  The largest category of poisoning was from non-opioid analgesics, such as ipbuprofen and paracetamol and 15-17 year old girls had the highest rate of poisoning by pharmaceuticals.

Almost two-thirds (63%) of poisoning cases among children and young people aged 10-24 were due to intentional self-harm, most common in people over 15. In these groups, intentional self-harm accounted for the largest proportion of hospitalised poisoning among both sexes, though the rates of intentional self-poisoning were higher among females in each age group.

Mentoring to Retain Newly Hired Nurses

Failure of the current transition experience from education to clinical practice is evident when new nurses exhibit characteristics of burnout and role stress during their first year of employment. Supporting the professional socialization of nurses is critical because engaged nurses are satisfied with their careers and stay longer at their employing institutions, which in turn decreases staff turnover and improves patient outcomes satisfaction.
This recent article looks at how mismanagement of a nurse's early professional experiences leads to lack of motivation, low productivity, and decreased quality of patient care.

Gazaway, S.b., Schumacher, A.M., Anderson L. (2016). Mentoring to retain newly hired nurses. Nursing Management (Springhouse), 47(8), 9-13. NSW Health Staff can access this journal via CIAP.

Diabetes Australia app

The Diabetes Australia app is a great resource for meal planning, latest news and health articles. It’s freely available for Android and Apple phones.You can also use the app to keep track of your appointments. Click the Health and Wellbeing section for information on when you need to see specialists and set a reminder.
You can also check out the great recipes, find a healthcare service nearby, and try the 30 minute yoga class by Diabetes Australia ambassador Sammy Veall and take the Fast Facts Quiz!
The updated version 1.02 is now available. Download from on Google Play or iTunes

Gardens and Health

This report from the Kings Fund sets out the evidence base on how gardens and gardening relate to health across the life-course. It highlights how, at different points in the health and social care system, gardens and gardening can make a strong contribution to keeping us well and independent.
The report includes a ‘menu’ of recommendations that aims to encourage the UK NHS, government departments, national bodies, local government, health and wellbeing boards and clinical commissioning groups to make more of the diverse health benefits of gardening in support of their priorities. In the future hopefully all new hospitals and those undergoing rebuilds in Australia will look at the benefits of gardens for both patients and staff.

 Buck David. (2016) Gardens and health: Implications for policy and practice