Cases Database

BioMed Central has developed a new resource CasesDatabase, a continuously-updated, freely-accessible database of medical case reports from 250 journals published by Springer, BMJ, PubMed Central and others.  There are almost 30,000 peer reviewed case reports listed and you can search by keyword, or perform a more advanced search. This aggregation of case reports facilitates comparison and provides clinicians, researchers, regulators and patients a simple resource to explore content, and identify emerging trends.

The Health of Australia's prisoners

A new report from the AIHW shows that Australia's prisoners have significant health issues, with high rates of mental health problems, communicable diseases, alcohol misuse, smoking and illicit drug use.  The Health of Australia's Prisoners 2012 shows that 46% of prison dischargees reported having ever been told they have a mental health issue (including alcohol and drug use issues), and 21% of those entering prison were taking mental health related medication. Over half (54%) of dischargees reported drinking alcohol at risky levels prior  to their current imprisonment but only 12% of dischargees reported having accessed an alcohol treatment program while in prison. Seven out of 10 (70%) prison entrants reported using drugs illicitly during the previous 12 months. These rates of alcohol and other drug misuse are all substantially higher than in the general community.

Health of Australia's males

The Australian Institute of Health and Welfare has recently published two new reports on men's health.

The health of Australia's males: from birth to youngadulthood (0-24 years) focuses on health conditions and risk factors that are age-specific (such as congenital anomalies) and those where large sex differences are observed (such as injury). In 2011, 3.7 million males (more than one-third of the Australian male population) were aged 0-24. While males aged 0-24 are more likely to be hospitalised or die from injury than females of the same age, they are similarly likely to be overweight or obese and less likely to smoke tobacco daily.  Almost 1 in 4 (23%) males aged 16-24 had experienced symptoms of a mental disorder, and 4 in every 1,000 males aged 18-24 had been diagnosed with a psychotic disorder. In spite of this, rates of help seeking among young males are low (13%).

The health of Australia's males: 25 years and over continues and completes the life course by focusing on males aged 25 and over.  Males aged 25 and over in 2011 can expect, on average, to live to 80 or over. One in 10 males aged 50-59 (11%) and 60-69 (10%) are, on a daily basis, at risk of injury resulting from excessive alcohol. In 2010 coronary heart disease was the leading cause of death in this group, followed by lung cancer.  Married males have lower mortality rates compared with their never married counterparts-8.1 compared with 12.8 deaths per 1,000 population.

Two Hearts One Future

 This report "Two hearts one future: a report of patients' & carers' experiences in surviving and coping with a first heart attack" finds that many heart attack survivors underestimate their risk of having a future heart attack. Preventative Health at the Baker IDI Heart and Diabetes Institute, under the auspices of the NHMRC Centre of Research Excellence to Reduce Inequality in Heart Disease, undertook a national survey to explore the experiences of individuals who survived their first heart attack (“subjects”). It also explored equivalent experiences in those caring (“carers”) for such individuals (but not necessarily the same ones who responded to the survey). Overall, these data provide a framework for improving our collective understanding of the causes and consequences of heart attack; particularly from the combined patient and carer respective. We found numerous misperceptions around heart attacks in those one might suspect would “know better”. We therefore need to improve education and support programs. Principal investigator was Professor Simon Stewart, with the Research team: Dr Yih Kai Chan, Dr Melinda Carrington and Ms Alicia Calderone. (APO 29 July 2013)

National Definitions for Elective Surgery Urgency Categories

A new report, National definitions for elective surgery urgency categories: proposal for the Standing Council on Health  was released today, 31st July, 2013, by the Australian Institute of Health and Welfare. In 2012, the Australian Institute of Health and Welfare and the Royal Australasian College of Surgeons worked together to develop national definitions for elective surgery urgency categories, at the request of the Standing Council on Health. The development of the national definitions resulted in a package of six integrated components proposed for adoption. This report presents the proposed definitions and components.

2013-14 Budget: Analysis of Health and Ageing Provisions

 In a tough political and budget year with several major initiatives to be funded - most notably the Gonski education reforms and the National Disability Insurance Scheme, now known as DisabilityCare Australia - the health and ageing section of the 2013-14 Budget has fared reasonably well. Overall the Budget contained $43 billion in savings over the forward estimates, much of which will be funneled into these new ‘critical investments.’ Of this, $1.22 billion over five years was taken from current health programs, with the majority of this ($902 million) from Medicare. This analysis was prepared by Lesley Russell at the Menzies Centre for Health Policy.  (APO 26 June 2013)

The Longitudinal Study of Australian Children: Annual Statistical Report 2012

This report, Growing up in Australia: the Longitudinal Study of Australian Children (LSAC), aims to provide the evidence base for future research and policy development to support family functioning and children's health and wellbeing. LSAC was initiated and is funded by the Australian Government Department of Families, Housing, Community Services and Indigenous Affairs, and is conducted in partnership with the Australian Institute of Family Studies (AIFS) and the Australian Bureau of Statistics (ABS). A consortium of leading researchers and experts from universities and research agencies provide advice to the study.
This is the third volume in the LSAC Annual Statistical Report series, which for the first time incorporates data from the fourth wave of the study. The purpose of these reports is to provide an overview of the data from the study and to address policy-relevant questions about aspects of Australian children’s lives and development. The reports make use of the longitudinal nature of LSAC data to describe continuities and change as children develop, as well as the dynamics of change in their families, neighbourhoods and communities. (APO 19 June 2013)

Emergency Services and Mental Illness

What do people affected by a mental illness and carers say about the help they receive from emergency services? What is needed to improve the response of police and ambulance services, mental health crisis teams, and hospital emergency departments when someone has a mental health crisis?
A survey was conducted between November 2012 and January 2013, using a convenience sample of 606 responses to an anonymous questionnaire accessed via www.sane.org (SANE Australia). Most respondents were female (77%) and aged predominantly 25-49 (36%). The diagnoses reported most frequently were depression (27%), bipolar disorder (18%), schizophrenia (15%), anxiety disorders (11%), and personality disorders (7%). The survey was intended to investigate the experience of respondents when they had used emergency services for an urgent mental health concern. Results have been used to identify barriers to effective care, and to make recommendations for improvements. This two-page article summarises the results. (APO 28 June 2013)

Health Provider Broadband Connectivity: a Review of Technical Requirements

Over the next 5 to 10 years high-speed broadband will enable a number of new services in the health sector including telemedicine consultations, electronic health records, eLearning for clinicians, and personalised medicine and participatory healthcare. Currently, there are a variety of piecemeal data connectivity arrangements with multiple connections and service providers in the health sector. For the healthcare sector to take advantage of high-speed broadband, delivering an efficient and effective transformation of service delivery and supply chain reform, integrated planning and better coordination of data connectivity are essential.

At present there is little information exchange and knowledge sharing across the health sector. This project, by Kathleen Gray and others at the Institute for a Broadband-Enabled Society, addresses this gap in knowledge and will develop a systematic and strategic map of health provider connectivity pathways. The research team will review scientific, technical and policy literature to analyse data connectivity requirements in health care environments producing a white paper that will inform debate within the sector. In addition to the literature review, empirical research will explore the typical current arrangements and future requirements among major Victorian health provider organisations. Finally, this project will develop service delivery models to support the financing, management and governance of data connectivity. (APO 3 July 2013)

Impact of technologies on young men's mental health

The Young and Well Cooperative Research Centre has published its first national survey, Game on: exploring the impact of technologies on young men's mental health and wellbeing.  Some troubling results from the survey of 14 young men aged 16-25 indicate the failure of our mental health system to address the needs of this group:

• Nearly one in five felt that life is hardly worth living
• Nearly one in ten had thought about taking their own life
• 42% had experienced psychological distress

The report suggests that using technologies which match current online behaviour could offer hope for improving the wellbeing of this group.  The young men who reported moderate to very high levels of psychological distress were more likely to talk about problems on the Internet, or to use the Internet to find information about their issues.

Use of seclusion during admitted patient care

This is the first time national seclusion information has been made available in Australia, and it shows that seclusion rates are falling. Seclusion is defined as confinement at any time of the day or night alone in a room or area from which free exit is prevented.
Reducing the use of seclusion is a national priority for mental health, and was formally endorsed by health ministers in the National safety priorities in mental health: a national plan for reducing harm. Information on seclusion in public mental health facilities has been made available on the Australian Institute of Health and Welfare's (AIHW) Mental Health Services in Australia website.

Changing how psychotropic medicines are used in residential aged care.

RedUSe is a new program aimed at reducing use of sedatives in aged care. It is led by Dr Juanita Westbury from the University of Tasmania (UTAS) and is based on extensive research she conducted with colleagues at the UTAS School of Pharmacy on the impact psychotropic medicines have on aged care residents.

The major aim of the program is to educate aged care professionals and promote awareness of drug mismanagement and chemical restraint of the elderly.

With nearly 60% of aged care residents prescribed psychotropic drugs and the percentage increasing, it has become a priority to address the over use of sedatives in our ever increasing number of dementia sufferers.

For more information or to register your interest in the RedUSe program contact Dr Juanita Westbury, RedUSe Program Lead at Juanita.Westbury@utas.edu.au

The Doctor’s Instagram

Figure 1 is being called the Instagram for doctors and is a free, safe way of sharing photos for healthcare proffessionals. The app is a collection of medical images submitted by doctors to share, collaborate and learn from.  Doctors are verified using their institutional email address as the app takes patient privacy very seriously.  It has a face detection program that automatically blocks out the face in a submitted photo and it includes other editing tools to remove other identifying features.  A HIPPA authorization digital consent form is also included.  Patients click the agree button then sign screen/form. There are still some issues with searching, but for an app to be this popular inside 3 months of launching in May 2013, it is doing something right.

Co-founder Dr Joshua Landry says; "I developed Figure 1 because I wanted a safe way to share medical images with the medical community, while protecting patients’ privacy."

Search tool provides easy access to Aboriginal and Torres Strait Islander health literature

The Lowitja Institute launched a new search tool called LIt. Search. This tool makes online searching for information about Aboriginal and Torres Strait Islander health easy. LIt.search enables users to search the worldwide PubMed database and confine their search to articles about Aboriginal and Torres Strait Islander health. With one click, the tool provides access to all available literature in this field and to 27 predefined search topics. Searches can be refined further by adding keywords.

More on the prevention and incidence of stroke

Protecting your brain and prevention and treatment of stroke is the title of a recent ABC Radio National Health Report.  A US study has shown clearly how every minute counts when treating ischemic stroke.  Jeffrey Saver from the University of California led the study of over 58,000 patients and was interviewed about his findings. "We demonstrated for the first time that haemorrhage is increased the longer you delay the start of the therapy. And we also confirmed definitively that death from stroke is reduced if you start the therapy sooner."  

In the same Health Report, Ann Hunt from the AIHW was interviewed.  Recently the AIHW released its report, Stroke and its management in Australia: an update.  Hunt relayed the good news that the stroke event rate in Australia fell by 25% between 1997 and 2009, but that the estimated number of strokes increased by 6%. The increase in numbers was attributed to the ageing population. 

Saver JL, Fonarow GC, Smith EE, et al. Time to treatment with intravenous tissue plasminogen activator and outcome from acute ischemic stroke. JAMA. 2013;309:2480-2488. Abstract