Today is the last day of 22q11.2 Awareness Week

22q11.2 Deletion Syndrome is a genetic syndrome. It is the result of a submicroscopic deletion on the long arm of Chromosome 22 in the “q11” region - deletion 22q11.

22q11.2 DS affects approx. 1 in 2000 - 3000 persons making it the second most prevalent genetic syndrome after Down syndrome. It is also the most common genetic syndrome associated with cleft palates and the second most common genetic syndrome associated with congenital heart defects

Read more about 22q11.2 Awareness week here and learn more about 22q11.2 Deletion Syndrome here on the 22q website.

Do you know the top 10 causes of death worldwide?

According to the World Health Organisation, of the 56.9 million deaths worldwide in 2016, more than half (54%) were due to the top 10 causes. Ischaemic heart disease and stroke are the world’s biggest killers, accounting for a combined 15.2 million deaths in 2016. These diseases have remained the leading causes of death globally in the last 15 years.

Chronic obstructive pulmonary disease claimed 3.0 million lives in 2016, while lung cancer (along with trachea and bronchus cancers) caused 1.7 million deaths. Diabetes killed 1.6 million people in 2016, up from less than 1 million in 2000. Deaths due to dementias more than doubled between 2000 and 2016, making it the 5th leading cause of global deaths in 2016 compared to 14th in 2000.

Read the WHO article here to discover what the remaining top causes of death around the globe are.

Drought-related stress among New South Wales farmers

A recent article in the Medical Journal of Australia brings attention to drought-related stress among New South Wales farmers based on the findings from a Australian Rural Mental Health Study (ARMHS), a longitudinal cohort study (2007–2013).
The study included a subset of 664 ARMHS participants (at baseline) who identified as living or working on a farm with the main outcome measures being personal drought-related stress (PDS), community drought-related stress (CDS), and general psychological distress. Farmers in NSW experience significant stress about the effects of drought on themselves, their families, and their communities. Farmers who are younger, live and work on a farm, experience financial hardship, or are isolated are at particular risk of drought-related stress. Medical practitioners who provide assistance to farmers and farming communities can contribute to initiatives that relieve stress about drought.

Read the complete article on The Medical Journal of Australia here.

Is coconut oil "pure poison"?

A 50-minute German lecture becoming a viral hit on YouTube might sound unusual, but the title of the talk by Karin Michels, the director of the Institute for Prevention and Tumor Epidemiology at the University of Freiburg and a professor at the Harvard TH Chan School of Public Health, has caused a bit of a stir online.

During the lecture, titled "Coconut Oil and other Nutritional Errors," Michels has made herself very clear with regard to dietary recommendations, and underlined that coconut oil is not healthy.

Its superfood status had already come under scrutiny last year after the American Heart Association (AHA) updated its guidelines, which recommended that people avoid the saturated fatty acids found in coconut oil.

Michels went a step further than to recommend avoiding the foodstuff, saying "coconut oil is pure poison" and "is one of the worst foods you can eat."

Read the full article on Science Alert here and watch the YouTube video here

Invasive Meningococcal Disease

As August and September are peak months for invasive meningococcal disease,  GPs should be alert for meningococcal symptoms in all age groups.

There has been a significant increase in invasive meningococcal disease (IMD) caused by serogroup W (MenW) and serogroup Y in NSW since 2013.

While MenW notifications decreased in NSW following the introduction of the vaccination program in 2017, the number of cases remain high compared to the period before 2015.

Symptoms of meningococcal disease are non-specific but may include sudden onset of fever, headache, neck stiffness, joint pain, a rash of red-purple spots or bruises, dislike of bright lights, nausea and vomiting.

NSW Health is offering meningococcal ACWY vaccine (Men ACWY) to Year 10 and 11 students through schools in 2018 and to Year 10 students in 2019.

GPs can offer free Men ACWY to any 15-19 year olds who have not been vaccinated at school until 31 December 2018. Find out more information here on North Coast Primary Health Network.

For more information on meningococcal disease please visit Meningococcal disease for health professionals 

Women's Health Faces a Healthy Future

The National Health and MedicalResearch Council has begun work on a new national health strategy for women. The National Women’s Health Strategy 2020–2030 aims to improve the health and wellbeing of all women in Australia over the next decade, especially those at greatest risk of poor health.

Minister for Health, Greg Hunt said the Strategy was the first since 2010 and was expected to be completed in 2019. ‘Women experience health challenges differently to men and we need to ensure that this is reflected in our health system’, Mr Hunt said.

"Maternal and infant health, chronic disease, healthy ageing and mental illness and other conditions affecting women will be a major focus of the new National Strategy."

He said 28 new medical research projects into women's health conditions were the first commitment of the Strategy.

"The projects will zero in on significant health challenges that affect Australian women, including breast cancer, maternal health, immunisastion rates and cardiovascular disease - a leading cause of death in Australian women," Mr Hunt said.

He said that although females born in Australia in 2015 could expect to live to 84.5 years, women continued to face health challenges. 

Read more here on PS News. 

Kawasaki Disease

Kawasaki disease, which is an acute, febrile vasculitis of childhood, can affect medium sized arteries, particularly the coronary arteries. Consequently, it is the leading cause of paediatric-acquired heart disease in developed countries, which is why it is important to have a high index of suspicion for Kawasaki disease in any child, especially with prolonged fever of unknown origin and also to refer to a paediatric facility promptly, as timely treatment reduces coronary artery damage.  Kawasaki disease is most common in children aged 6 months to 4 years and other symptoms can include strawberry tongue, skin rash and the peeling of skin on the hand and feet.

Read an article about this rare disease by Daniel Golshevsky, Michael Cheung and David Burgner on Australian Family Physician here or download the PDF here

For more information also visit The Kawasaki Disease Foundation Australia

Mapping Primary Care in Australia

Primary care policy needs an overhaul to ensure all Australians, especially the poor and the elderly, get the best possible health care, according to a new Grattan Institute report.

Australians' access to general practice varies according to their wealth. Two-thirds of patients are bulk-billed for all their visits to the GP, but the financial barriers for those who are not can be high. About 4 per cent of Australians say they delay seeing a GP because of the cost.

The report finds that the funding, organisation and management of primary care has not kept pace with changes to disease patterns, the economic pressure on health services, and technological 

advances.

You can download the report for free here.

Hal Swerissen, Stephen Duckett, and Greg Moran. (2018). Mapping primary care in Australia. Grattan Institute.

Wellness Programs: do they work?

Wellness programs sometimes claim to save money by reducing health care spending, and the observational analysis usually supports this belief. This report tells us about a unique study published earlier this year looking into the effectiveness of the wellness program at the University of Illinois.
It evaluated the program (iThrive) implemented at a large employer with 12,000 staff in the US, using both an observational AND a randomized controlled study approach.
They took the 3,300 staff who accepted the wellness program, then analyzed them the way a typical observational trial would, comparing those who participated with those who didn’t. After one year there were no significant effects of the wellness program on the many outcomes examined, with two exceptions: employees are more likely to have received a health screening and to believe that the employer places a priority on worker health and safety.

Jones, D., Molitor, D., & Reif, J. (2018). What Do Workplace Wellness Programs Do? Evidence from the Illinois Workplace Wellness Study (No. w24229). National Bureau of Economic Research.  

Low quality healthcare is increasing the burden of illness and health costs globally

Poor quality health services are holding back progress on improving health in countries at all income levels, according to a new joint report by the OECD, World Health Organization (WHO) and the World Bank.

Today, inaccurate diagnosis, medication errors, inappropriate or unnecessary treatment, inadequate or unsafe clinical facilities or practices, or providers who lack adequate training and expertise prevail in all countries.

The situation is worst in low and middle-income countries where 10 percent of hospitalised patients can expect to acquire an infection during their stay, as compared to seven percent in high income countries. This is despite hospital acquired infections being easily avoided through better hygiene, improved infection control practices and appropriate use of antimicrobials.. At the same time, one in ten patients is harmed during medical treatment in high income countries.

These are just some of the highlights from Delivering Quality Health Services – a Global Imperative for Universal Health Coverage. The report also highlights that sickness associated with poor quality health care imposes additional expenditure on families and health systems.

Read the full report here
Watch the webinar here

People with dementia should be involved in discussions about their care, says NICE

People with dementia should be involved in discussions about their care, says NICE: Professor Gillian Leng, deputy chief executive at NICE, reflects upon the difficulties people with dementia can experience, and how she hopes the guidance will help them, the family and their carers:

Dementia is a highly complex and challenging condition. It can present differently from person to person, having a huge impact on the patient, their family and their carers.

The new NICE guideline highlights the need to properly train staff and says that carers should be helped to improve support for people living with dementia.

The recommendations focus on person-centred support, placing a particular emphasis on involving people with dementia in every decision about the care they receive.

The guideline also discusses the various forms of dementia, how it may affect individuals in different ways and how support will therefore be adapted for each person.

Coordination of health care: experiences with GP care among patients aged 45 and over 2016

Shedding light on patient experiences with health care is becoming increasingly important as health systems strive to be more responsive to the needs of the people using their services. This report presents the first findings from the 2016 ABS Survey of Health Care at the Primary Health Network (PHN) area level, as well as variations in the use of and experiences with GP care by sociodemographic groups. It shows that the majority (98%) of patients have a usual GP or place of care and that 80% of patients have both a usual GP and place of care. Nationally, more than 8 in 10 patients (84%) felt that the quality of care they received from their usual GP or others in their usual place of care in the previous 12 months was excellent or very good; this ranged from 71% to 87% across PHN areas.
View or download the report here.