General health checks in adults - Cochrane review

General health checks in adults for reducing morbidity and mortality from disease is an interventional review recently published by the Cochrane Library.  The aim was to determine whether general health checks do more harm than good, emphasising patient-relevant outcomes such as morbidity and mortality. Health checks were defined as screening general populations for more than one disease or risk factor in more than one organ system. The authors noted that general health checks are unlikely to be beneficial as they did not reduce morbidity or mortality, overall or for cardiovascular or cancer causes, although the number of new diagnoses was increased.  

Norman Swan interviewed the lead author, Lasse Krogsboll, on ABC Radio National's Health Report about this last week.  You can read the transcript or listen to the podcast here.

Krogsbøll LT, Jørgensen KJ, Grønhøj LC, Gøtzsche PC. (2012). Cochrane Database of Systematic Reviews, Issue 10. Art. No.: CD009009, DOI: 10.1002/14651858.CD009009.pub2

Oral health reports

The Australian Institute of Health and Welfare has released two new reports on oral health care, using data from the 2010 National Dental Telephone Interview Survey:

Families and their oral health provides information on the oral health and oral health impacts experienced by Australian children and seeks to determine if this experience is closely related to the oral health of their parents. Additionally, the report explores the role family circumstances play in children's experience of oral health. 

Chronic conditions and oral health reports on the impact of oral conditions on people with a chronic condition including asthma, cancer, heart disease, diabetes, arthritis, stroke, kidney disease, high blood pressure and depression. The report found that people with a chronic condition were more likely to experience toothache, be uncomfortable with their oral appearance, avoid certain foods due to oral problems and to experience orofacial pain. They were also more likely to have fewer than 21 teeth, making it difficult to chew food. 

Ward rounds - best practice guidelines

Ward rounds in medicine: principles for best practice has just been published by the Royal College of Physicians with the Royal College of Nursing.  It sets out core recommendations and principles for best practice for conducting medical ward rounds, including their structure, preparation and scheduling, as well as patient participation and protection, nursing involvement, the use of safety checklists and discharge planning. 

It calls for the multidisciplinary team – doctors, nurses, pharmacists, therapists and allied health professionals – to be given dedicated time to participate, with clarity about individual roles and responsibilities during and after ward rounds.  

Australian Clinical Trials website

Patients suffering chronic diseases will benefit from the launch of a new website that offers easier access to clinical trials of new drugs, treatments and medical procedures. Minister for Health, Tanya Plibersek recently launched the Australian Clinical Trials website in response to the needs of consumer groups, the pharmaceutical industry and research institutions. 
 
The website includes explanations of the clinical trial process; contact details for trials; a section for trial sponsors; real stories from patients, doctors and researchers, and a section for researchers on ethics, legislation and getting started.

Palliative care services in Australia

This inaugural report on palliative care services in Australia provides detailed information on the national responses to the palliative care needs of Australians.  Details from a range of data sources for 2009-10, and where available 2010-11, are presented, as are changes over time.

Since 2000-01, the number of palliative care separations reported in public and private hospitals has increased by 51% to almost 56,000 in 2009-10, and almost $3 million in MBS benefits was paid for palliative medicine specialist services in 2010-11. Over the 5 years to 2010-11 the amount of benefits paid on palliative medicine specialist services subsidised through the MBS has more than doubled.

There were 172 specialist palliative medicine physicians and 5173 nurses working principally in palliative care in Australia in 2009.

Landmark study on IV fluids

A landmark study by Australian and New Zealand researchers, CHEST (The Crystalloid vs Hydroxyethyl Starch Trial) has found that a widely used starch fluid for resuscitation of patients in intensive care units provides no clinical benefit and its use results in increased acute kidney failure (haemodialysis) when compared to normal saline.

Published in the New England Journal of Medicine, the study randomly assigned 7000 patients who had been admitted to an intensive care unit to either the starch fluid or the normal saline. The primary outcome was death within 90 days. Secondary outcomes included acute kidney injury and failure and treatment with renal-replacement therapy.  The results of the trial showed that, in patients in the ICU, there was no significant difference in 90-day mortality between patients resuscitated with 6% HES (130/0.4) or saline. However, more patients who received resuscitation with HES were treated with renal-replacement therapy.

Myburgh, J.A. et al “Hydroxyethyl Starch or Saline for Fluid Resuscitation in Intensive Care” NEJM October 17, 2012DOI: 10.1056/NEJMoa1209759

BreastScreen monitoring report

The Australian Institute of Health and Welfare has just released BreastScreen Australia monitoring report 2009-10.  BreastScreen Australia aims to reduce illness and death resulting from breast cancer through organised screening of women. This report is the latest in an annual series that presents national statistics monitoring the program against performance indicators. More than 1.3 million women in the target age group of 50-69 were screened in 2009-2010, a participation rate of 55%. Breast cancer mortality is at a historic low, at 43 deaths per 100,000 women.

Population Health Research Network (PHRN)

The Population Health Research Network (PHRN) has been stablished with the backing of the Australian Government (as part of the National Collaborative Research Infrastructure Strategy) and is supported by every Australian state and territory.  The PHRN will enable existing health data from around Australia to be brought together and made available for health and health related research purposes. Health care planners, providers and policy makers will be able to use this research to respond more effectively to the changing needs of the Australian population.

Healthy lifestyle workers' web resource

A new on line portal to support Australia's Healthy Lifestyle Workers was recently launched by the Australian Indigenous HealthInfoNet.  Healthy Lifestyle Workers are employed across Australia as part of the Australian Government's Closing the gap - Indigenous chronic disease initiative.   The resources on this site The resource aim to provide the healthy lifestyle workforce with access to quality information, including key facts, publications, resources, programs and organisations on a range of topics such as tobacco use, nutrition, physical activity, diabetes, and kidney health.

Mental health services in Australia

Mental health services in Australia - in brief 2012 provides an overview of the national response to the mental health needs of Australians. It includes information on mental health service provision, available mental health resources and the changes that have occurred in these over time.

Estimates from the 2007 National Survey of Mental Health and Wellbeing (SMHWB) suggest that 7.3 million Australians (45% of the population aged 16–85) will experience a common mental disorder (a mood disorder, such as depression; anxiety or a substance use disorder) over their lifetime. Each year, 20% of the population in this age range, or 3 million Australians, are estimated to experience symptoms of a mental disorder. The second National Survey of People Living with Psychotic Illness conducted in March 2010 (Morgan et al. 2011) estimated that almost 64,000 people in Australia had a psychotic illness, most commonly schizophrenia, and were in contact with public specialised mental health services each year.

Health statistics for NSW

Health Indicators for NSW, authored by Talina Drabsch and published by the NSW Government, contains a selection of health statistical indicators in New South Wales and aims to provide a snapshot of health trends.  There is a focus on the overall picture in NSW, with breakdowns by local health districts, and, where relevant, comparisons with other Australian States and Territories.  Topics include statistics on births, life expectancy, disability, death, substance use, mental health, immunisation, health expenditure and hospital separations.

Private Lives 2: the Second National Survey on the Health and Wellbeing of Gay, Lesbian, Bisexual and Transgender (GLBT) Australians

Private Lives 2 (PL2) is a report on the second national survey of the health and wellbeing of gay, lesbian, bisexual, and transgender (GLBT) Australians. The first Private Lives (PL1) was released in 2006 and was, at that time, the largest survey of its kind conducted anywhere in the world. In 2011, 3,835 GLBT respondents successfully completed PL2. PL2 was an on-line survey publicised, nationally, and backed up by some hard copies of the survey which were distributed to GLBT seniors organisations across the country. The questionnaire consisted, primarily, of forced-choice (quantitative) questions but included a small number of open-ended or qualitative questions. The authors are William Leonard and others.

The project was supported by beyondblue with funds from The Movember Foundation, with additional funds provided by the Victorian Department of Health and a La Trobe University faculty grant. The project was managed jointly by Gay and Lesbian Health Victoria (GLHV) and the Australian Research Centre in Sex, Health and Society (ARCSHS) La Trobe University. (APO 30/4/12)

Footprints in Time - the Longitudinal Study of Indigenous children (LSIC)

The study aims to improve the understanding of, and policy response to, the diverse circumstances faced by Aboriginal and Torres Strait Islander children, their families and communities. The Footprints in Time study was conducted by the Department of Families, Housing, Community Services and Indigenous Affairs (FaHCSIA) under the guidance of the Footprints in Time Steering Committee, chaired by Professor Mick Dodson AM. The study aims to improve the understanding of, and policy response to, the diverse circumstances faced by Aboriginal and Torres Strait Islander children, their families and communities. (APO 18/9/12)
The study was broken up into three waves:
Wave 1: topics include family life, growing up strong, learning and doing, and strong souls and safe communities.
Wave 2: Changes in family life structure and new topics such as child support, stolen generations and pre-school.
Wave 3: This report uses a measure called the Level of Relative Isolation (LORI) to describe the geographical characteristics of families in the study

Addressing Uncomfortable Issues: the Role of White Health Professionals in Aboriginal Health

This research by Annabelle Wilson investigated the role of white health professionals in addressing Aboriginal health in South Australia. Set within the discipline of nutrition and dietetics and the area of obesity prevention, it explored the practice of White health professionals from the point of view of Aboriginal and White workers. This research, currently in the form of an unpublished Doctor of Philosophy thesis, arose from practice dilemmas the author experienced as a dietitian working in rural and remote South Australia. The setting for this research was the eat well be active Community Programs, a community-based, childhood obesity prevention program in South Australia. In order to conduct ethical research, the author worked closely with Aboriginal community members and workers, through building and maintaining relationships and activities of reciprocity.

This research identified that there are a number of elements to the practice of White health professionals that make it ideal when they are working with Aboriginal communities. However, such ideal practice does not always occur and this research sought to identify why. The organisation, profession and individual were identified as systems within the wider system of Aboriginal health. In summary, this research identified that moving forward in Aboriginal health requires White health professionals to look at themselves, which generally requires them to address uncomfortable issues. (APO 11/10/12)

Supporting Older People who are Experiencing Mental Distress or Illness

The Benevolent Society has released the seventh in its series of community aged care Research to Practice Briefings.  Briefing 7, Supporting older people who are experiencing mental distress or illness, reviews Australian and international research evidence on the symptoms and treatments of mental illness in older people to provide guidance for community care practitioners in their day-to-day work of supporting older people. Mental distress or illness is not a normal part of ageing.  However, like people of any age, older people can be vulnerable to mental illness. This Briefing was developed in partnership with the National Ageing Research Institute (NARI). (APO 30/08/12)