Companion animals and the health of older people

The International Federation on Ageing has published Companion animals and the health of older persons as one response to the projected costs associated with caring for ageing populations.  A literature review examined the relationship of older people living both independently and in long-term care facilities, including dementia sufferers and people with a mental illness, with their pets. The study focused on the physical, mental, emotional and social health of these people, as well as the role of animals in their perceptions of inclusion in their community.  The economic impact of animals interacting with older people was also examined and some promising initiatives explored, including one in Victoria and one in NSW.  It was acknowledged that research on this topic has been very limited.

Coeliac disease: where are we in 2014?

Published recently in Australian Family Physician by Kristin Kenrick and Andrew S Day, Coeliac disease: where are we in 2014? seeks to summarise the current knowledge and management of this autoimmune disease which affects at least one in a hundred Australians.

Coeliac disease is characterised by chronic inflammation of the small-intestinal mucosa and triggered by eating gluten. Many people with the disease remain undiagnosed because of the varied manifestations of symptoms it can produce.   The article presents up-to-date information on CD as we now understand it, with recommendations on whom to test and how to test for it, and how to manage patients once they are diagnosed.

Australian Family Physician Volume 43, No.10, October 2014 Pages 674-678.

Women, work and the menopause

According to this report, 78% of women aged between 45 and 54 participate in the Australian workforce, representing over a million women potentially experiencing menopause while at work.
Women, work and the menopause: releasing the potential of older, professional women is a report from the Australian Research Centre in Sex Health and Society at La Trobe University and authored by Gavin Jack and colleagues.  It explores:

• Older women’s health and well-being
• The relationship between menopause-related symptoms and work outcomes  
• Actual and desired levels of organisational support for women experiencing menopause
• Work-related and organisational factors that exacerbate or ameliorate women’s experiences of menopause in the workplace
• Women’s first-hand experiences, beliefs and attitudes towards menopause at work

Mistakes made when interpreting research

Two researchers at the Australian National University have written a useful article in The Conversation, The 10 stuff-ups we all make when interpreting research.  Will J Butler and Rod Lamberts explain very simply some of the pitfalls we can easily fall into when trying to critically appraise a study.

Some of these "stuff-ups" include using the results of just one study to prove a point, confirmation bias (where we look for studies that confirm what we already believe), confusing the merits of qualitative and quantitative results and giving too much weight to significance and peer review.

Medication errors: an overview for clinicians

The Institute of Medicine in the US has estimated that medication errors cause one in 131 outpatient deaths and many more morbidities.  "Medication errors: an overview for clinicians" is an article recently published in Mayo Clinic Proceedings and its authors provide an overview of medical errors, including definitions, incidence, risk factors, avoidance strategies and legal consequences.

Medication errors can be precipitated by many factors, ranging from the confusion which may arise from the similar labeling or naming of different drugs to poor communication between health professionals.  Strategies that have been used to overcome these problems are discussed.

Wittich CM, Burkle CM, Lanier WL, Mayo Clinic proceedings.89(8):1116-25.  http://dx.doi.org/10.1016/j.mayocp.2014.05.007

Contact your health library for the full text.

Dying in America report

Continuing the theme of palliative care and dying, this consensus report has just been published by the US Institute of Medicine. Dying in America:  Improving quality and honoring individual preferences near the end of life argues that improving palliative care services not only enhances the quality of life of the patient, but could be more economically sustainable.

Recommendations from the report include health professionals communicating better to patients about their choices and advanced care planning, there should be more rigorous education for clinicians in the issues of palliative care and there should be greater financial incentives for people to die in their own homes.

Dying Well - Grattan report

The Grattan Institute has published Dying Well, a report by Hal Swerissen and Stephen Duckett about how we die in Australia. According to the report, 70% of Australians would like to die at home, but only 14% actually do so.  About 50% die in hospital and a third in residential care. Dying in Australia is more institutionalised than most other countries and this is linked to medical and community attitudes as well as a lack of funding for home-based care.

The report recommends more public discussion, including an education campaign, about the limits of health care as death approaches and the need to focus on end-of-life care.  It also proposes the widespread adoption of advance care plans that ensure people’s desires for the end of life are met.  “The baby boomers are growing old and in the next 25 years the number of Australians who die each year will double,” Professor Swerissen says. “We need the courage to promote a national discussion about a subject that we might dislike but cannot avoid.”

You can also read Swerisson and Duckett's article in The Conversation, A Good death:  Australians need support to die at home.  It's a good summary of their full report.


Swerissen, H and Duckett, S., 2014, Dying Well. Grattan Institute ISBN: 978-1-925015-61-

Palliative Care Services in Australia 2014

The Australian Institute of Health and Welfare has published this annual report about services available to Australians in palliative care, and changes over time.  There were over 57 600 palliative care related separations from public and private hospitals in 2011-12 and almost $4.7 million MBS payments were made for palliative medicine specialist services in 2012-13.

Detailed information is provided in the report about definitions of palliative care and who provides it.  Both GP and specialist encounters are explored, and data provided on the overall palliative workforce, medications and services and facilities.

Combating the Obesity Epidemic

A two-part program on Australia's obesity problems have recently aired on ABC Radio National's Health Report.  Combating the Obesity Epidemic Part 1 and Part 2 discuss the latest reports that almost two thirds of Australians are now overweight or obese, and how willpower, surgery and drugs are being used to tackle the problem.

Guests include Professor John Dixon from Baker IDI Heart and Diabetes Institute in Melbourne, Associate Professor Garett Smith, a surgeon from Royal North Shore Hospital and Guy Maddern, Professor of Surgery at the University of Adelaide.  In addition one man's battle with his weight is charted over time. You can read the transcripts or download the audio at the above links.

World Alzheimer Report 2014

Alzheimer's Disease International has published  World Alzheimer Report 2014, Dementia and Risk Reduction: An analysis of protective and modifiable factors, which examines the evidence for the existence of modifiable risk factors for dementia in four key domains: developmental, psychological and psychosocial, lifestyle and cardiovascular conditions. The report makes recommendations to drive public health campaigns and disease prevention strategies.

The report calls for dementia to be integrated into both global and national public health programs alongside other major non-communicable diseases. Among the many findings, the report reveals that diabetes can increase the risk of dementia by 50%, and with obesity and inactivity being risk factors for diabetes, they should be targeted.

Australia's health expenditure 2012-13

Expenditure on Australian health was estimated according to this AIHW report at $147.4 billion in 2012-13.  This was only 2.4% higher than the previous year and the lowest growth since 1990-91.  Health Expenditure Australia 2012-13 shows this to be largely a result of the Australian Government health funding falling by 1.9%, and a very low growth in state funding.  Non-government funding however was quite strong at 9.7%.

There was an analysis of this report on ABC Radio National's Health Report recently, when Norman Swan discussed the implications with the Director of the AIHW, David Kalisch.  You can see the transcript of the interview or listen to the audio here.

Dementia on ABC Big Ideas

Dementia was the topic on a recent episode of Big Ideas on ABC radio.  It is estimated that 332,000 Australians suffer from dementia, and this is likely to triple over the next forty ears unless a cure is found. The costs to our health system are enormous and much research is going into Alzheimer's Disease, but can we prevent or cure this disease?

Guests on this program include Professor Kaarin Anstey, Director of the Centre for Research on Ageing at ANU, Dr Zoe Terpening from the Brain and Mind Research Institute at the University of Sydney, Professor Henry Brodaty, Director of the Centre for Health Brain Ageing, UNSW and Ita Buttrose, Alzheimer's Australia ambassador.

You can listen or download the program here

Public health advocacy toolkit

The third edition of the Advocacy in Action Toolkit from the Public Health Advocacy Institute of Western Australia is now available for download.  It is a practical resource full of examples and case studies demonstrating how advocacy strategies can be applied across different issues. The toolkit addresses the challenges faced when advocating on an issue and provides practical solutions.  It also provides tips on working with the media. 

Effectiveness of Aboriginal Community Controlled Health Services

The Deeble Institute for Health Policy Research has compiled an evidence brief:  The relative effectiveness of Aboriginal Community Controlled Health Services compared with mainstream health service.  ACCHSs have been funded by the Australian Government to provide primary health care services to Aboriginal people.  The authors of this brief found a lack of evidence on the effectiveness of these health services.  "This means that it is impossible to make categorical statements, one way or the other, about the effectiveness of ACCHS.  That said, a range of studies have been conducted which, while mostly small-scale, indicate that the services provided by ACCHS are valued by their Aboriginal clients."

Prevalence of osteoporosis in Australia

Because osteoporosis has no obvious symptoms until a trauma fracture occurs, it is difficult to estimate the number of people living with this condition.  Estimating the prevalence of osteoporosis in Australia looks at both the epidemiology and the impact of osteoporisis in people over 50 years of age.  It is shown that it markedly increases with age and is more common in women than in men.

In 2011-12 the estimated prevalence of self-reported diagnosed osteoporosis among those aged 50 and over living in the community was 15% of women and 3% of men, according to the Australian Health Survey.  However, a recent study which measured bone density in a population sample estimated that 23% of women over 50 had osteoporosis and 6% of men.