Oral health and dental care in Australia

Oral health and dental care in Australia - Key facts and figures 2015 has been published by the Australian Institute of Health and Welfare.

The report includes statistics such as the fact that in 2010, 55% of 6-year-olds had experienced decay in their baby teeth and 48% of 12-year-olds had experienced decay in their permanent teeth.  In 2013, 16% of adults with natural teeth had experienced toothache in the previous 12 months and 27% reported feeling uncomfortable about their dental appearance.  Also in 2013, approximately 19% of adults aged 65 and over had no natural teeth.  

In 2013, 64% of people aged 5 and over had visited a dental practitioner in the previous year and half had some level of private health insurance with dental cover. Total expenditure on dental services outside hospitals was $8,706 million in 2012-13, an increase from $5,945 million in 2002-03. There were approximately 56 dentists, 5 dental prosthetists, 5 dental hygienists, 3 dental therapists and 3 oral health therapists employed in Australia per 100,000 people.

Becoming a clinician researcher in allied health

Balancing research with clinical demands is difficult and requires a strategic approach. This study in the Australian Health Review involved interviewing research-active allied health professionals at regional health services in Queensland to try to pin down the factors that influence successful research projects integrated into clinical practice. 

The authors concluded that a number of factors enable clinical researcher success, including "Library resources - having a good librarian is really helpful." An understanding of the clinician researcher career trajectory may also help to develop strategies to support research capacity building.

Harvey, D. et al. Becoming a clinician researcher in allied health - Australian Health Review - 28 January 2016.

Preventing falls in hospitals - the 6-PACK program

An Australian study recently published in the BMJ evaluated the 6-PACK falls reduction program in six hospitals, involving 31,000 patients. The intervention included a fall risk tool and the use of one or more of six interventions:  "falls alert" signs, supervision of patients in the bathroom, ensuring walking aids are in easy reach, a toileting regimen, a low-low bed and a bed/chair alarm.  A randomised controlled study allocated patients to either the usual care, or the 6-PACK program.

Barker and her colleagues concluded that "no difference was seen in falls or fall injuries between groups. High quality evidence showing the effectiveness of falls prevention interventions in acute wards remains absent. Novel solutions to the problem of in-hospital falls are urgently needed."

The related editorial, by Frances Healey, examines the results more closely, noting that in the US around one million patients fall in hospitals every year, and over 250,000 in the UK, "numbers that dwarf almost all other problems with patients’ safety."  Healey recommends that local learning can be key, with incident reports being analysed to focus staff efforts where falls typically occur.

Barker, Anna L. et al. 6-PACK programme to decrease fall injuries in acute hospitals: cluster randomised controlled trial  BMJ 2016;352:h6781
 
Healey, Frances Preventing falls in hospitals (Editorial) BMJ. 2016; 352:i251  

Health in 2016 Cheat Sheet

Stephen Duckett from the Grattan Institute has published a handy update on Australian health in The Conversation.  Health in 2016: a cheat sheet on hospitals, Medicare and private health insurance reform updates us on the problems in the current systems, reviews currently being undertaken and the likelihood of government action on health reform.  "The health care headaches in 2016 are, in fact, the same ones we faced a decade ago, albeit different in severity and symptoms. They include population growth, ageing and the rise of chronic disease; inequality in access to care and health outcomes; technological change (the good, the bad and the expensive) and the seemingly inexorable rise in health costs."

Zika virus - sources of information

www.cdc.gov/zika

There has been much in the media in the past few weeks about the Zika virus affecting Central and South America.  Here are some authoritative sites with up to date information: 

• World Health Organisation (WHO) - Zika virus disease, Zika Virus Fact sheet, Zika virus disease: Questions and answers, Briefing notes on Zika and Microcephaly  
• U.S. National Library of Medicine (NLM) Zika Virus Health Information Resources
• U.S. National Institutes of Health (NIH) Zika Virus: An Emerging Health Threat 
• Centers for Disease Control & Prevention (CDC) - Zika Virus - various pages, information, fact sheets and posters   
• Australian Department of Foreign Affairs and Trade - Travellers' bulletin - Zika virus

Yesterday's issue of The Conversation included two short articles about the Zika virus:

Suresh Mahlingam and Michael Rolph from Griffith University are the authors of Here's why we don't have a vaccine for Zika (and other mosquito-borne viruses).  They conclude, "Zika causes mild fever in humans that on its own does not make a strong argument for a vaccine. But the possible link to microcephaly in unborn children, even though not yet definitely confirmed, makes vaccine development – and necessary funding – an urgent priority." 

Grant Hill-Cawthorne from the University of Sydney mounts a case for keeping calm about the virus, in Zika emergency status a cause for alert, not alarm. 

Safe management of expressed breast milk

The Sax Institute has published Evidence check: safe management of expressed breast milk. The authors summarise the evidence on this topic in hospitals, the home and in the community and conclude that expressed breast milk can be safely stored at -20 degrees Celsius for up to 12 months, however frozen storage at any temperature will result in degradation of the immunological components of EBM that provide protection against contamination.

An extensive literature review revealed that the main issues were the possible contamination of EBM due to improper handling, the loss of nutritional value during transport and storage and the small risk that the "wrong baby" might receive milk from someone other than their mother.

The results of this review uphold many of the findings and recommendations of the current policy developed by NSW Health (Maternity – Breast Milk: Safe Management) and the latest NHMRC infant feeding guidelines.

Domestic and family violence in specific situations

The Australian Institute of Family Studies has recently released a number of briefing papers and reports on various aspects of domestic and family violence, authored by Monica Campo:

Intimate partner violence in lesbian, gay, bisexual, trans, intersex and queer communities: key issues - looks at this issue within LGBTIQ relationships and notes the absence of acknowledgement in government and policy responses

Domestic and family violence in pregnancy and early parenthood - analyses ABS statistics on the number of pregnant women and young children affected by domestic violence

Domestic and family violence in regional, rural and remote communities - a brief overview of the particular problems faced by people affected by violence away from major cities.

Children's exposure to domestic and family violence: key issues and responses - this paper presents an overview of the effects of domestic and family violence on children, and outlines a range of evidence-based responses.

Predictions on response to anaesthesia

Research on brain activity recently published in PLOS Computational Biology may help doctors track the likelihood of patients waking up during surgery.

One of the researchers, Srivas Chennu, authored an article about the research in The Conversation, which explains the results, which  help us "better understand the transition to unconsciousness during sedation, and how this transition varies from person to person."  They gave a steadily increasing dose of propofol to twenty people who were asked to respond to various stimuli during different levels of sedation as the activity of their brain networks was measured. "We found that it was actually the strength of their brain networks before sedation that predicted why some eventually lost consciousness while others did not."

The original paper: Brain Connectivity Dissociates Responsiveness from Drug Exposure During Propofol-Induced Transitions of Consciousness.  Srivas Chennu, Stuart O’Connor, Ram Adapa, David K. Menon, Tristan A. Bekinschtein.  Published: January 14, 2016 DOI: 10.1371/journal.pcbi.1004669

Medical Devices Safety Update

The Therapeutic Goods Administration (TGA) has released the latest edition of its medical device safety bulletin. Topics covered in this issue include:

• Battery management a growing issue
• Safety alerts issued for two knee implants – related to the ACS fixed-bearing cementless porous coated tibial component and the Scorpio Series 7000 cementless beaded tibial components, both of which are used in total knee replacements
• IUCDs (intrauterine contraceptive device) and uterine perforation
• Recent safety alerts, relating to Anatomic Locked Plating System, Silimed medical devices, InSync III cardiac resynchronisation therapy pacemakers, Optisure dual coil defibrillation leads, and EndoBarrier duodenal-jejunal bypass liner with delivery system

Medical Devices Safety Update. Volume 4, Number 1, January 2016

Women in NSW 2015

Women in NSW 2015 provides findings on a range of social and economic outcomes for women across health and wellbeing, education and learning, work and financial security, leadership and representation; and safety and justice. This is the only report of its kind for women in Australia and this year for the first time, the complete indicator data set is also available in the accompanying NSW Women’s Report Card 2015.

The report can be accessed at https://www.women.nsw.gov.au/womens_data

Engaging the Medical Staff

"There are three main reasons why hospital leaders need strong medical staff leaders as allies. First, medical staff leaders are more influential with their peers than managers are. Second, they serve as the leadership team’s main connection to frontline doctors. Finally, they provide essential advice and input on hospital initiatives to the organisation's management team."

A recent publication from The Advisory Board Company suggests from recent research that hospitals do not have a strong doctor engagement. You can read and learn how focusing on communication, leadership development, and staff enfranchisement can change the relationship you have with your doctors, and cement truly great medical staff engagement across your organisation.

You can download the study here or check with your library if they have the book for loan. The Advisory Board Company. Engaging the Medical Staff. Partnering With Doctors to Achieve Mutual Goals

Virtual Issue: Risk Factors for Adolescent Drinking

Heavy alcohol use in adolescence has been associated with a number of negative outcomes, including increased risks for the development of substance-related problems. This virtual issue of Alcoholism: Clinical and Experimental Research, focuses on a broad range of risk factors associated with adolescent alcohol use and misuse.   

The seven papers in the issue cover a broad range of risk factors from individual characteristics, such as impulsivity and genetics, to environmental factors, such as peer and drinking contexts. Numerous studies have indicated that environmental, genetic and developmental factors all influence behavioral outcomes.

Alcoholism: Clinical and Experimental Research. Risk Factors for Adolescent Drinking. Virtual Issue

Primary Care and Population Health

The latest issue of Public Health Research and Practice focuses on the relationship between primary care and population health and how it can be strengthened to improve health outcomes.

The themed articles discuss the potential for prevention through integration between primary health care organisations and public health services and programs; the role of the new Primary Health Networks; a lifestyle modification program in Australia; and a research article examining community-based care after hospital discharge. Articles are free to access.

Public Health Research & Practice, 2016;26(1)

Research Highlights from National Institutes of Health

With NIH support, scientists across the United States and the world conduct wide-ranging research to improve health. Included in the sections below are some of the research accomplishments, many receiving top scientific honors. 
Clinical Advances :NIH accomplishments in the prevention, diagnosis, and treatment of human disease. These include a test to tailor breast cancer tumor treatments, a noninvasive treatment to help paralyzed men gain movement, and a tool that may predict suicide risk.

Promising Medical Advances : NIH findings with potential for enhancing human health include advances in Ebola research, progress in fighting HIV, and the development of custom 3-D printed nerve scaffolds to aid tissue regeneration.

Insights from the Lab : Noteworthy NIH advances in basic research include charting human genetic variation across the globe, the discovery of lymphatic vessels in the central nervous system, and insights into energy-burning fat cells. 

British Journal of Anaesthesia Special Issue: A Selection of Nine Educational Reviews

There are nine educational review articles for the 2015 BJA/PGA published in this free Special Issue of the British Journal of Anaesthesia. The articles cover a number of topics including regional anaesthesia, acute kidney injury and noncardiac surgery in older adults.

2015 BJA/PGA Special Issue: A Selection of Nine Educational Reviews
Volume 115 suppl 2 December 2015