HIV management: A guide for clinical care

The Australasian Society for HIV Medicine has updated the HIV Management: a Guide for Clinical Care monograph. This clinical resource has been extensively reviewed and updated to incorporate the latest advances and research in the management of HIV. It is an invaluable reference handbook for HIV S100 community prescribers and clinicians. The resource aims to improve the care and wellbeing of people with HIV infection in Australasia. The 2009 edition is divided into the following three sections: mechanisms, phases and diagnostic; therapeutics and monitoring; and clinical manifestations of HIV disease.

Click here to download or order your free copy or for further information.

Need a Cochrane refresher?

The ACC Guide to the Cochrane Library (previously named the NICS Guide) has been developed to help introduce people to the Library and provide some initial guidance on how to find information within it. Since October 2002 all Australians have had access to The Cochrane Library as a result of funding by the Australian Government. To view the Guide click here.

Free PDA & iPhone/iPod touch Resources

The Medical College of Wisconsin has formulated a list of resources suitable to download freely to PDAs, iTouch and iPhones. Handheld devices have become an integral part of clinical education and a valuable tool in the clinical setting providing quick access to reference materials at the point of care. This is a fantastic list of mostly free resources you can download.

SUPPORT Tools for evidence-informed health Policymaking (STP)

Knowing how to find and use research evidence can help policymakers and those who support them to do their jobs better and more efficiently. Health Research Policy and Systems journal has published a series written for people responsible for making decisions about health policies and programmes and for those who support these decision makers. The series is intended to help such people to ensure that their decisions are well-informed by the best available research evidence. Each article in the series presents a proposed tool that can be used by those involved in finding and using research evidence to support evidence-informed health policymaking. The series addresses four broad areas: 1. Supporting evidence-informed policymaking 2. Identifying needs for research evidence in relation to three steps in policymaking processes, namely problem clarification, options framing, and implementation planning 3. Finding and assessing both systematic reviews and other types of evidence to inform these steps, and 4. Going from research evidence to decisions. To view and download the articles, click here.
The series describes a set of tools that have been developed by the SUPporting POlicy relevant Reviews and Trials (SUPPORT) project, an international collaboration funded by the European Commission’s 6th Framework (http://www.support-collaboration.org/

Career Choice and Practice Location of Medical Graduates

The one-year Flinders University program for undergraduate education located in rural general practices has set the standard for medical education in Australia and internationally. The results of this study suggest that half of these graduates are on a rural pathway. The article considers why the other half is not, applying unique typology that includes 'The Frustrated' and 'The Metro Docs'. 'A new model to understand the career choice and practice location decisions of medical graduates' (From: NRHA eforum - 15 December 2009)

Expectations and Experiences Associated With Rural GP Placements

'Expectations and experiences associated with rural GP placements'Placement experiences have the potential to influence medical career decision-making. What, then, are the pre-placement expectations and actual experiences associated with rural GP placement. This unique, small South Australian study will make thought-provoking reading for those interested in the rural GP workforce.http://www.rrh.org.au/articles/showarticlenew.asp?ArticleID=1264 (From: NRHA eforum - 15 December 2009)

First Six Monthly Report for Remote Indigneous Services

The Australian Government has released the first six monthly report from the Coordinator General for Remote Indigenous Services on the progress being made in delivering essential services to people living in 29 priority Indigenous locations across Australia. First report into Remote Indigenous Service Delivery (From: NRHA eforum - 15 December 2009)

Australian Government Contribution to Hospital Care

Whether you are a public patient in a public hospital or a patient using private insurance in a private hospital, the Australian Government ends up contributing around the same amount of funding, according to a report by the Australian Institute of Health and Welfare (AIHW) "Funding sources for admitted patients in Australian hospitals, 2005-06". (From: NRHA eforum - 15 December 2009)

Northern Territory Child Health Checks

Many children have benefited from health services following health checks in the Northern Territory, but not all children have received follow-up services for their health problems, according to a report released by the Australian Institute of Health and Welfare "Progress of the Northern Territory Emergency Response Child Health Check Initiative: final report on results from the Child Health Check and follow-up data collections". The report shows that more than 10,000 Aboriginal and Torres Strait Islander children aged between 0 and 15 years received a Child Health Check (CHC) under the Northern Territory Emergency Response (NTER) between July 2007 and June 2009. (From: NRHA eforum - 15 December 2009)

Caesarean Rate Stabilises as Baby Boom Continues

The rate of women undergoing caesarean section has stabilised for the first time in more than ten years according to a report "Australia's mothers and babies 2007" from the AIHW. The report also shows more women are having babies and more are delaying having children until later in life. The baby boom continued with over 12,000 more births in 2007 than in 2006 and 14% more than in 2004. The perinatal death rate was 10.3 per 1,000 births and fetal and neonatal deaths were 7.4 per 1,000 births and 2.9 per 1,000 live births respectively. Young maternal age, maternal Indigenous status and multiple births were associated with higher rates of perinatal deaths. (From: NRHA eforum 15 December 2009)

Prevention of cardiovascular disease, diabetes and chronic kidney disease: targeting risk factors

A new report released by the Australian Institute of Health and Welfare (AIHW) shows that while a lot is being done to reduce the risk of developing cardiovascular disease, diabetes and chronic kidney disease, significant levels of risk still remain. Cardiovascular disease (CVD), diabetes and chronic kidney disease (CKD) account for around a quarter of the burden of disease in Australia, and just under two-thirds of all deaths. These three diseases often occur together and share risk factors, such as physical inactivity, overweight and obesity, and high blood pressure. This report includes information on the national prevalence of the main risk factors for CVD, CKD and diabetes as well as population initiatives and individual services that aim to prevent or control these risk factors. It shows the prevalence of some risk factors is increasing-notably obesity, which rose from 11% of adults in 1995 to 24% in 2007-08. This is the first report to present a systematic approach to monitor prevention in Australia, providing a baseline for future monitoring. Download report here.

A guide to what works for depression – Beyondblue

This booklet, written for beyondblue by Anthony Jorm, Nick Allen, Amy Morgan and Rosemary Purcell, provides a comprehensive review of all known treatments for depression, including medical, psychological and complementary and lifestyle interventions. The user-friendly booklet rates treatments with a 'thumbs up, thumbs down' scale and features a tear-off bookmark summary of treatments that are proven to work. Click here to download the booklet or order from the beyondblue website http://www.beyondblue.org.au/ or by calling 1300 22 4636 (local call).

Diabetes, medicines and me

The National Prescribing Service (NPS) and Diabetes TASMANIA have launched a new educational series aimed at people with type 2 diabetes, which addresses medicines use issues. The videos are designed to be used by health professionals and community organisations when discussing the management of type 2 diabetes with newly diagnosed patients. The series comprises 11 segments which cover issues including the types of medicines used to manage type 2 diabetes, the best ways to manage medicines, and what patients should discuss with their healthcare providers.
The videos range from one to five minutes and you may download, display print and reproduce the videos in unaltered form only for non-commercial use either personally or within your organisation.

Australian Guideline for the Prevention of Venous Thromboembolism (VTE).

Australians at risk of potentially fatal blood clots will benefit from NHMRC’s new Australian Guideline for the Prevention of Venous Thromboembolism (VTE). This Guideline provides evidence-based recommendations for the prevention of venous thromboembolism (blood clots), in adult surgical and medical patients and pregnant women admitted to Australian metropolitan, regional and rural hospitals.Thirty thousand people are hospitalised each year in Australia due to VTE. Approximately 2,000 Australians die each year from VTE. Eighty percent of these cases are related to prior hospitalisation for either surgery or acute illness. The Guideline is intended for use by doctors, nurses, pharmacists and allied health professionals but also provides useful information for consumers and those responsible for the quality and safety of healthcare. Download the guideline here.

Improving Stroke Management in Australian Emergency Departments

The National Health and Medical Research Council (NHMRC) has released a stroke care package designed to improve care for people presenting to the emergency department with acute stroke and transient ischaemic attack (TIA). Stroke is Australia’s second single greatest killer after coronary heart disease and is a leading cause of disability. There are approximately 60 000 new and recurrent strokes in Australia each year, that’s one stroke every 10 minutes. This number will increase as the population ages. According to the National Stroke Foundation (NSF), one in five people having a first-ever stroke die within one month and one in three die within a year. Effective treatment in the emergency department can reduce disabilities and improve long term patient outcomes.
The package comprises a small number of evidence-based interventions, grouped together and applied to the management of a particular condition. Download the package here.

Information site for social workers

Information for practice is a site sponsored by the New York University School of Social Work; the Division of Social Work and Behavioral Science, Mount Sinai School of Medicine; the Institute for the Advancement of Social Work Research, and the Society for Social Work and Research. It's Mission Statement is "To help social service professionals throughout the world conveniently maintain an awareness of news regarding the profession and emerging scholarship."
The site is updated regularly and includes links to news items, open access journals, grey literature, meta analyses and guidelines.

Cycling safety and injuries

"With a dramatic increase in cycling, comes a plethora of new safety issues on the roads. Doctors, politicians, planners and cyclists agree it will mean changing the way we design, govern and use our roads." ABC Radio National's Background Briefing this week presented their program on On-Road Cycling. It is estimated that there has been a 48% increase in people riding their bikes to work over the last five years, which has led to a huge increase in Emergency Department presentations for cycling injuries - especially in the 40-49 year age group. Police records for cycling accidents are greatly underestimated as so many go unreported.

Australian Eye Health

A Guide to Australian Eye Health Data describes key Australian data collections which indicate the prevalence and outcomes of eye diseases and injuries and eye health care utilisation. Published today December 7 by AIHW, it updates the 2007 edition. Since the publication of the first edition there have been a number of developments in the availability of eye health data, most notably sources of information about eye health among Aboriginal and Torres Strait Islander people. The report is available via the Internet only.

Women and health: today's evidence tomorrow's agenda

Despite considerable progress in the past decades, societies continue to fail to meet the health care needs of women at key moments of their lives, particularly in their adolescent years and in older age. These are the key findings of the WHO report Women and health: today's evidence tomorrow's agenda. The report provides the latest and most comprehensive evidence available to date on women's specific needs and health challenges over their entire life-course. The report includes the latest global and regional figures on the health and leading causes of death in women from birth, through childhood, adolescence and adulthood, to older age. You can download or order the full report here.

Closing the Gap Collection

Closing the Gap Clearinghouse provides access to a collection of quality information on what works to overcome Indigenous disadvantage. It is a collection of evidence-based research on overcoming disadvantage for Indigenous Australians and can be searched via the Quality-Assessed Collection—a focused collection of material with individual quality assessments or
the General Collection—a broad collection of material related to the COAG building blocks.

E-Health

The National E-Health Transition Authority (NEHTA) has been established to accelerate the adoption of e-health by supporting the process of reform in the Australian health sector. It is hoped that E-health will greatly enhance both the quality and timeliness of healthcare information, delivering substantial benefits to healthcare consumers, healthcare providers and the Australian health sector as a whole. Australian governments are committed to implementing e-health around existing electronic health initiatives to transform the way information is used to plan, manage and deliver healthcare services.The National E-Health Transition Authority Strategic Plan (2009-2012) is available here.

They also answer the question of "What is an IEHR?"

TIME: Toolkit of Instruments to Measure End-of-life Care

A fundamental barrier in the quality of care at the end of life is the lack of measurement tools. These measurement tools should identify opportunities for improving medical care, examining the impact of interventions or demonstration programs, and holding institutions accountable for their quality of care. Brown University has put together an authoritative bibilography of instruments to measure the quality of care and quality of life for dying patients and their families. Based on these reviews, Toolkit instruments have been created, which are available on this site at no charge. They also have Links to other relevant sites. You can also do a Database search limiting your search to such subjects as Pain, Hospice or Home Care or Grief.

Creative Ageing Seminar

A public seminar 'From creative ageing to end-of-life in rural and remote Australia', was an integral part of this year's CouncilFest. The various presentations can be accessed from the above link. This is a valuable site for those who were unable to attend and for those who did attend but are keen to recap the salient points made by an impressive list of keynote speakers. (From: NRHA e-forum 2 December, 2009)

New reports on General Practice activity

The AIHW today released General practice activity in Australia 2008-9. This report presents results from a national study of general practice activity called the BEACH program. From April 2008 to March 2009, 1,011 general practitioners recorded data about 101,100 GP-patient encounters involving the management of 149,462 problems. For an 'average' 100 encounters, GPs recorded 106 medications, 34 clinical treatments, 17 procedures, 9 referrals to specialists and 4 to allied health services, and ordered 46 pathology and 10 imaging tests.

In addition, the AIHW published General practice activity in Australia 1999-00 to 2008-09: 10 year data tables which also stems from the BEACH program and details changes that have occurred over the last decade in the characteristics of general practitioners and the patients they see; the problems managed and the treatments provided. "In adult patients aged 18 years and over, between 1999–00 and 2008–09 prevalence of overweight increased from 33% to 36%, obesity from 19% to 25%, daily smoking decreased from 19% to 15% and at-risk alcohol consumption remained static at 26%."

More than 85% of the population visit a GP at least once in any year. From March 2008 to April 2009, there were about 112 million general practice consultations paid for by Medicare, up from 101 million in 1999–00; an average of 5.1 per person, a similar visit rate to 1999–00 (5.4 visits per head). The GPs themselves are aging, feminising and becoming more qualified.

Draft Australian Guidelines on ADHD

The Royal Australasian College of Physicians (RACP) and National Health and Medical Research Council (NHMRC) have made available updated draft Australian Guidelines on Attention Deficit Hyperactivity Disorder (ADHD) Due to an ongoing investigation in the US, the Council of the NHMRC has not been able to ratify the guidelines as yet, but the draft is accessible.

More than 350,000 Australian children and adolescents are estimated to have ADHD and this draft updates the guidelines published in 2005 which have now been withdrawn. The NHMRC site linked to above also contains other useful information to assist parents and medical professionals in treating and recognising ADHD, including a systematic literature review.

Anonymous NSW Hospital Blog

The latest issue of the British Medical Journal reports on how Australian hospital staff have set up an anonymous blog to voice concerns about cutbacks. Called "Who Will Speak for Us" the blog is being used to draw public attention to their concerns about cutbacks to service. The link to the blog is http://whowillspeakforus.blogspot.com/

The website says, "It has to be anonymous because all staff of Sydney West Area Health Service are required not to speak to the media as part of their employment contract. Where is the accountability of the system if staff are gagged?" The bloggers from Katoomba Hospital, west of Sydney, have taken elaborate steps to protect their anonymity.

Life Tables, Australia, 2006–2008

The Australian Bureau of Statistics has released Life Tables 2006-2008. A life table is a statistical model used to represent mortality of a population. In its simplest form, a life table is generated from age-specific death rates and the resulting values are used to measure mortality, survivorship and life expectancy. NSW life tables for 2001-2003 onwards are also available at the ABS site.

Indigenous health report - concerns for males

The AMA has released its eighth Indigenous Health Report Card, this year putting the focus on the tragic state of health of Indigenous males - boys, adolescents and men. It found, for example, that an Indigenous boy born during 2005-2007 can expect to die at age 67, nearly six years earlier than an Indigenous girl, and 11.5 years earlier than a non-Indigenous boy born in the same period. Also, in 2004-06, Indigenous males were more than twice as likely to be hospitalised for mental health and behavioural disorders than non-Indigenous males.

Fourth National Mental Health Plan 2009-14

The fourth national mental health plan: an agenda for collaborative government action in mental health 2009-2014 has been released by the Australian Department of Health and Ageing. This plan identifies key actions and priority areas for developing "a mental health system that enables recovery, that prevents and detects mental illness early and ensures appropriate treatment and community support for all Australians with a mental illness."

The plan has five priority areas for government action in mental health:
* Social inclusion and recovery
* Prevention and early intervention
* Service access, coordination and continuity of care
* Quality improvement and innovation and
* Accountability - measuring and reporting progress.

Systematic reviews for Managers

The PPD/CCNC database is a searchable repository of over 800 systematic reviews about health policy, finance and management. Developed by McMaster University's Program in Policy Decision Making (PPD) in partnership with the Canadian Cochrane Network and Centre (CCNC), this database provides links to abstracts, user-friendly summaries and full-text reports whenever possible.

"To help managers and policymakers find and use these reviews, we’ve identified as many management- and policy-relevant reviews as possible, categorized them in ways that will make it easy to retrieve citation details and summaries of them (whenever possible), and made the database available online."

Proposed Denticare scheme explained

The Parliamentary Library has released a Background Note providing an outline of the proposed Denticare scheme, including the dental services to be covered, cost estimates and financing arrangements. Responses to the proposal and some key issues for further discussion are highlighted.

Quality Care at the End of Life

Presentations from Palliative Care Australia Conference are now available for download. "Together! Cultural connections for quality care at the end of life", was held in Perth in September 2009 and has over 50 papers to look at including clinical, spirituality, rural, ethical, aged, paediatric and nursing issues . Run by Palliative Care Australia, they also have some excellent Resources to download on their website.

Alcohol & other drug treatment services in Australia

Alcohol continues to be the number one drug of concern for Australians seeking treatment for drug or alcohol issues, according to a report released on Saturday by the Australian Institute of Health and Welfare (AIHW).
The report, Alcohol and other drug treatment services in Australia 2007-08: report on the National Minimum Data Set, found that treatment for alcohol issues has continued to increase, with treatment for alcohol comprising 44% of treatment episodes in 2007-08 compared with 38% in 2002-03. Alcohol treatment was followed by treatments for cannabis (22% of treatment episodes), amphetamines (11%) and heroin (11%).

Counselling was the most common form of treatment followed by withdrawal management.

Addiction, free will & self control

Download the transcript & audio "Addiction, free will & self control" from the ABC Radio National All In The Mind program. Join Natasha Mitchell and guests in a roundtable interrogation of how the brain sciences are changing our understanding of addiction, and the powerful consequences for notions of free will, responsibility and culpability. At the end of the transcript are some excellent references to recent articles, books and links to other relevant All in the Mind programs.

Centre for Evidence Based Practice Australasia

The Royal Melbourne Hospital continues to lead the way in developing online evidence based clinical knowledge resources by launching a virtual Centre for Evidence Based Practice Australasia . CEBPA is not a typical website but an evolving 'cloud' (or collection) of EBP resources from across Australia and New Zealand, with particular emphasis on Australasian content. The aims of CEBPA are:
1. to provide an additional layer of resources to that already provided by Australasian EBP sites,
2. to provide a central point for Australasia-wide EBP collaboration, learning and knowledge-sharing and
3. to facilitate the translation of (evidence-based) knowledge into action.

The Royal Melbourne Hospital Director of Education, A/Prof Peter Morley, said: “The CEBPA fills a gap in the current health infrastructure and potentially plays a major role in improving the quality of healthcare. There is also potential for saving costs across diverse areas of healthcare, with flow-on benefits in clinical audit, clinical governance and safety."

To view the CEBPA cloud, go to http://www.cebpa.info/ and click on Login, then follow the prompts. Once you have logged on you will then see an expanded Menu (as well as expanded discussion forums).

Patient Survey 2009 Statewide Report

The Patient Survey 2009 Statewide report has been released and summarises findings from the NSW Health Patient Survey, covering seven patient categories across the vast majority of public healthcare facilities in NSW. Surveyed patients were treated in February 2009 and the report is supported by each of nine NSW Area Health Services.

NSW Health has also made available the Patient Survey 2009 Summary in powerpoint form and details the experience of patients in 2009. It gives feedback about patient experience obtained from over 220,000 patients across NSW. 322 facilities/services across NSW participated in the 2009 survey.

NSW Government releases report on health reforms

The NSW Government yesterday released the first six month report of the independent panel set up to report on the implementation of the Caring Together reforms. The report also includes an audit on the progress of the reforms. “As described by John Walsh, the Government has moved swiftly to act and today six months on from the release of our Caring Together Health Action Plan for NSW, we are pleased to reach this milestone and release of the independent report,” Ms Tebbutt said.
However the Sydney Morning Herald headlines on November 19 state "Doctors sick of failure to fix ailing hospitals". "Since Peter Garling, SC, handed down his landmark report a year ago, calling for an urgent overhaul of the state's hospital system, little has changed on the ground, the survey conducted for the Australian Medical Association and the Australian Salaried Medical Officers concluded." AMA (NSW) President Dr Brian Morton said the Independent Panel’s review of the State Government’s Caring Together reforms highlighted the need to better engage health professionals in hospital decision making.

Australia's welfare 2009 is the ninth biennial welfare report of the Australian Institute of Health and Welfare. It is a very comprehensive and authoritative source of national information on welfare services in Australia. Topics, and some of the key findings, include:

• Children, youth and families - 15% of Australia's children lived in jobless families in 2006


• Ageing and aged care - Home and Community Care (HACC) continues to reach the largest number of older clients in community care.


• Disability and disability services - The number of people with disability doubled between 1981 and 2003, to reach an estimated 3.9 million Australians.


• Carers and informal care - Most informal carers are women aged from 25-54 years, and they live with the person for whom they care.


• Housing and housing assistance - Current demand for affordable housing exceeds supply


• Homelessness - There are high rates of homelessness in regional and rural areas, and Aboriginal and Torres Strait Islander people are over-represented in the homeless
  population.

Birth and Perinatal Death Statistics

The Australian Bureau of Statistics has recently released these two new reports:
3301.0 - Births, Australia, 2008: This publication contains statistics on perinatal deaths for Australia, 1999 to 2007. Australia has again set a new record for the number of births in a year, according to figures released by the Australian Bureau of Statistics (ABS). A total of 296,600 births were registered in 2008, surpassing the previous record years of 2007 (285,200 births) and 1971 (276,400).

3304.0 Perinatal Deaths Australia 2007: These datacubes present statistics on the number of perinatal deaths, for year of registration by state or territory of Australia, sex and cause of death classified to the World Health Organisation's International Classification of Diseases (ICD). Perinatal deaths comprise stillbirths (fetal deaths) and deaths of infants within the first 28 days of life (neonatal deaths).

Bush Support Services

The Bush Support Services Line (formerly the Bush Crisis Line) is a 24 hour confidential telephone support service for workers, and their families, who work in health related services in remote and isolated situations. It is staffed by qualified psychologists with remote and cross cultural experience, is toll free and available from anywhere in Australia. (From: NRHA eforum 13 November 2009)

2009 AMA Indigenous Health Report Card

The AMA has released its eighth Indigenous Health Report Card, this year putting the focus on the tragic state of health of Indigenous males - boys, adolescents and men. Indigenous males are much more likely to die earlier from preventable causes than non-Indigenous males and Indigenous females. At every age - from boyhood to manhood - Indigenous males experince higher rates of diseases and conditions that are totally preventable. There is evidence that the loss of status, self-esteem and sense of purpose experienced by many Indigenous men is intimately bound up with their poor health as both a cause and an effect. In this Report Card, the AMA sets out some solutions to help improve the health and quality of life of Indigenous males, and gives examples of Good News Stories where innovative programs are providing healthier lifestyles for men and boys alike. (From: NRHA eforum 13 November 2009)

Anxiety website

Established by the National eTherapy Centre (NeTC) at Swinbourne University of Technology, and funded by the Federal Department of Health and Ageing, "Anxiety Online is a comprehensive online mental health service offering information, assessment and treatment programs ("eTherapy") for the anxiety disorders".

The website includes three main areas:

• Information: Information and resources for general anxiety and specific anxiety disorders.
• Clinical assessment: An online psychological assessment program which provides individual feedback on the nature of your anxiety problems and recommendations for what to do about it.
• Treatment programs: For each of the specific anxiety disorders, either self-help programs or Therapist-assisted programs are offered.

Public health expenditure in Australia, 2007-08

Australia’s spending on public health activities — those of a preventive, protective or health promoting nature — grew by 21% in 2007-08, according to a report released by the Australian Institute of Health and Welfare (AIHW). The report Public health expenditure in Australia 2007-08 shows total expenditure on public health was $2,159 million in 2007-08, or $102 per person on average. This was an increase of $444 million on what was spent in the previous year. The growth was mainly due to a large increase in expenditure on organised immunisation, specifically the implementation of the National Human Papillomavirus (HPV) vaccination program.
Full report

Hazardous Substances Data Bank (HSDB®) Has Added First Set of Nanomaterial Records

The National Library of Medicine® (NLM) Hazardous Substances Data Bank (HSDB) has added its first set of nanomaterial records. Nanotechnology is the study of matter on an atomic and molecular scale -- structures 100 nanometers or smaller. A nanometer (nm) is one billionth of a meter. Like other HSDB records, the nanomaterial records are peer reviewed and contain information on toxicity, manufacturing and use, chemical and physical properties, environmental fate and exposure, and more. NLM Resource announcement (From: NLM New files for the week of Nov 2, 2009)

Caesarean Sections - Health Report feature

Last Monday, ABC's Health Report presented the first of a two part series about Caesarean Sections. You can podcast, listen or read the transcript of Part One on their website, and tune in for Part Two next Monday on Radio National at 8.30 am.

Caesarean sections are becoming more common. In Australia one in three babies are born this way, and once a mother has one caesarean she has at least a 50% chance of having another one in a following pregnancy. In about 18% of cases the Caesarean is performed for no medical reason but because the mother has requested it, and the worry is that there can be serious consequences for both the mother and the baby. Part one looked at reasons for the rise in this type of birth and interviewed mothers and obstetricians who defended the right to choose. Next week's episode will look at the risks and consequences of the increase in caesareans.

Training for rural and remote allied health professionals

SARRAH (Services For Australian Rural and Remote Allied Health) provides an online Remote and Rural Transition Toolkit, aimed specifically at training allied health professionals in the special requirements for rural and remote practice. "This toolkit will be useful for a range of Allied Health Professionals entering the remote and rural context, including students on clinical placement, graduates commencing work, or experienced practitioners commencing work in a remote or rural area for the first time."

This education project was funded by the Australian Government Department of Health and Ageing and it includes a swathe of resources, learning modules, competencies, personal stories, and a discussion forum.

National Aboriginal and Torres Strait Islander Social Survey, 2008

This publication (ABS Cat 4714.0) presents summary results from the 2008 National Aboriginal and Torres Strait Islander Social Survey (NATSISS). The survey was conducted by the Australian Bureau of Statistics (ABS) from August 2008 to April 2009, collecting information from approximately 13,300 Indigenous Australians living in private dwellings in remote and non-remote areas, including discrete communities. The 2008 NATSISS provides information on a range of demographic, social, environmental and economic indicators, including: personal and household characteristics; geography; language and cultural activities; social networks and support; health and disability; education; employment; financial stress; income; transport; personal safety; and housing. Information from the 2008 NATSISS contributes to existing data on Indigenous people and the formulation of government policies and legislation. (From National Rural Health Alliance eforum 3/11/09)

Doing it tough: Carers in rural Australia

Doing it tough: Carers in rural Australia - Australian Institute of Family Studies (AIFS)A groundbreaking study of carers in regional and remote Australia has revealed that those living in drought-affected areas are less likely to be employed full-time. The Australian Institute of Family Studies has undertaken the study - The Tyranny of Distance? Carers in Regional and Remote Areas of Australia - on behalf of Carers Australia and Commonwealth Financial Planning. It is the first study in Australia to look at carers in rural and regional Australia, and the first to examine the impact of the drought on carers employment. (From National Rural Health Alliance eforum 3/11/09)

Cutting through: using health information technology for effective chronic care delivery

Cutting through: using health information technology for effective chronic care delivery. Could it be that Australia is finally on a path that will lead us forward on the e-health agenda after all the false starts we have encountered over the last decade? This report was prepared in early 2009 by Information Integrity Solutions (IIS) for the Health Information Exchange Sub-Committee to report to the Australian National Consultative Committee on e-Health (ANCC on e-Health). It was prepared in response to the increasing need to cut through the difficult issues arising in relation to chronic care and to find a sustainable, effective and efficient solution. (From National Rural Health Alliance eforum 3/11/09)

Nutrition and preventative health in Indigenous futures

The Commonwealth Scientific and Industrial Research Organisation (CSIRO), in conjunction with the Cooperative Research Centre for Aboriginal Health (CRCAH), hosted the 3rd National Indigenous Science and Research Roundtable entitled "Nutrition and Preventative Health in Indigenous Futures" on 4th-5th August 2009 in Adelaide, South Australia. This Roundtable fulfilled a commitment to the delegates from the inaugural Roundtable, held in Broome in July 2008, to hold future discussions with a focus on health and nutrition for Indigenous Australians. (From National Rural Health Alliance eforum 3/11/09)

What do Aboriginal women think is good antenatal care?

What do Aboriginal women think is good antenatal care? This report documents the first phase of the research project entitled Developing a Health Information System to Support Continuous Improvement in Antenatal Care for Aboriginal Women in the Central Australian Region. The project consisted of four major elements: a literature review; consultations with Aboriginal women; quantitative investigative components; and the implementation and trial pilot of a health information system for antenatal care in the primary health care setting. (From National Rural Health Alliance eforum 3/11/09)

Cost effectiveness of needle and syringe programs this year

Return on investment 2: evaluating the cost-effectiveness of needle and syringe programs in Australia 2009 has just been published by the National Centre in HIV Epidemiology and Clinical Research, UNSW and the Department of Health and Ageing.
The report comes out very positively in favour of the gains made in these programs from 2000 - 2009, estimating that 32,050 HIV infections and 96,667 HCV infections have been averted. This has meant "substantial healthcare cost savings to government, and substantial gains in disability-adjusted life years ... For every dollar currently spent on the programs, more than four dollars will be returned (in addition to the investment – that is, five times the investment) and approximately 0.2 days of disability-adjusted life gained. Over a longer time horizon there is even greater return."

Body Image strategy for Australia

There has been some media attention in the past few days to the acceptance by the Minister for Youth Affairs, Kate Ellis, of the Proposed National Strategy on Body Image. The report was developed by the National Advisory Group on Body Image which was established by Ms Ellis earlier this year. The chair of the Advisory Group is former Cosmopolitan Editor Mia Freedman and it also includes model and television producer Sarah Murdoch (who you might have seen on the cover of the Women's Weekly this week without air-brushing).
The report encourages advertisers, the media and the fashion industry to promote more positive body image messages and includes a Voluntary Industry Code of Conduct on Body Image which recommends using healthy weight models, realistic and natural images of people and disclosure when images of people have been digitally manipulated.

Osteoporosis affects 1 in 3 men over 60

For World Osteoporosis Day 2009 last week, Australian men were being asked "How strong are your bones?" Osteoporosis Australia announced the release of a new consumer brochure targeted at men. The vision of Osteoporosis Australia is 'Healthy Bones for all Australians for life' and the site has a number of resources for health professionals including fracture calculators and Prevent the Next Fracture guides.

HealthMash.com

HealthMash is a new search engine that bills its mission as promoting health and well-being by providing relevant information of high quality from trusted health sources on the Web. The Health Knowledge Base stores explicit knowledge about health conditions, causes, treatments and procedures etc. and can focus on important facets of a health topic, e.g. specific drugs and/or supplements used to treat a disease or condition like sciatica. Results include news, video, images, clinical trials, articles, books and blogs.

Primarily consumers, but physicians will also find useful information in HealthMash. The advantage of Healthmash is is the range of media searched – including twitters and blogs.

More breast cancer cases, but early detection and improved treatment lead to fewer deaths

More women are being diagnosed with breast cancer than ever before, but death rates continue to fall, according to a report released today by the Australian Institute of Health and Welfare (AIHW) and National Breast and Ovarian Cancer Centre (NBOCC). Breast cancer is one of the most common cancers in Australian women with over 12,000 new cases diagnosed in 2006, and projections suggest that the number of new cases will continue to grow. A total of 2,618 women died from breast cancer in 2006, making it the second most common cause of cancer-related deaths for women. Trend data indicate that breast cancer mortality rates for females have been declining since the mid 1990s and that outcomes for women diagnosed with breast cancer have improved over recent decades. These and other data in this report provide a comprehensive picture of breast cancer in Australia including how breast cancer rates differ by Indigenous status, country of birth and geographic area.

Indigenous issues in rural emergency departments

'“They just don’t like to wait”—A comparative study of Aboriginal and non-Aboriginal people who did not wait for treatment, or discharged themselves against medical advice from rural emergency departments' is a paper recently published in The Australasian Emergency Nurses Journal by NCAHS's own Leanne Wright. Leanne works across Port Macquarie Base Hospital and Kempsey District Hospital as a Nurse Practitioner in emergency services.

Leanne also presented her paper at the Emergency Nurses International Conference at the Gold Coast last month and won the best rural paper at the conference, awarded by the Australian Society for Emergency Medicine. Her research found that Aboriginal people were 1.5 times more likely to leave rural emergency departments prior to being seen by the medical officer, and 2.5 times more likely to “discharge against medical advice” than non-Aboriginal people. "The study replicated urban trends for rates of “did not wait” and “discharge against medical advice” for Aboriginal people, supporting indirect evidence of service dissatisfaction for this group. Rural communities often provide limited or no choice for alternative after-hours health care arrangements, leading to potential adverse outcomes for this vulnerable group."

eviQ Cancer Treatments Online - new website

The Cancer Institute of NSW is replacing its CI-ScAT website with this new, more user-friendly point of care resource. From this week, the eviQ Cancer Treatments Online site will provide all breast, colorectal, lung, gynaeoncology, lymphoma, myeloma, and radiation oncology treatment information, as well as some nursing information. The other areas will be gradually migrated from CI-ScAT, which still remains operational until mid-December. Registration is free and the site includes such evidence-based goodies as:

• Cancer treatment protocols, all with accompanying patient information available as PDFs
• Chemotherapy dosing calculator and a Biological Equivalent Dose (BED) calculator
• Information presented in tumour specific areas

Medical and Nursing workforce reports

The AIHW has just released two reports compiling workforce information from 2007.

Nursing and midwifery labour force 2007 reports that the total number of registered and enrolled nurses 305,834, an increase of 12% since 2003. In that time, the proportion of nurses aged 50 years or over increased from 28% to 33%. The number of full time equivalent nurses per 100,000 population increased by 8% and the profession continued to be predominantly female, with females comprising 90% of employed nurses in 2007.

The Medical Labour force 2007 report found that supply of employed medical practitioners increased between 2003 and 2007, from 279 to 305 full-time equivalent practitioners per 100,000 population, which reflected a 20% rise in practitioner numbers. Women made up 34% of practitioners in 2007 compared to 32% in 2003. The average hours worked by male practitioners declined from 47.5 to 45.9 hours, while hours worked by female practitioners remained steady at 37.6 hours.

Farm life and mental health

The Mental Health of People on Australian Farms : the facts 2008, has been published by a Farm Health & Safety joint research venture on the initiative of the Australian Government. "This chartbook provides available relevant data relating to the mental health and wellbeing of the people in agriculture – the changing structure of family farms, the ageing profile of farmers and farm managers, common pressures reported by farmers that are difficult to cope with, available data relating to prevalence of mental health disorders, and suicide data relating to the farming population in Australia."

The report found that suicides and levels of self-reported distress amongst farm workers was high, due to such factors as drought, finance, meeting government requirements and family pressures. It was concluded that there is a need to work with farming families to reduce their levels of distress and there is a description of the NSW Farmers Blueprint for Mental Health and Wellbeing.

Best practice guidelines for mental health promotion programs: Children & Youth

This web resource from the Canadian Center for Addiction and Mental Health provides the health practitioner with current evidence-based approaches in the application of mental health promotion concepts and principles for children and youth. It is envisioned that these guidelines will support both the inclusion and the sustainability of mental health promotion concepts. This resource is intended to support practitioners in incorporating best practice approaches to mental health promotion interventions directed toward children (7-12 years of age) and youth (13-19 years of age.

Reposted from GWAHS Libraries Blog

Health promotion of physical activity

Health Promotion of Physical Activity is the latest in a series of papers published regularly by the Primary Health Care Research and Information Service (PHCRIS). This simple 2-page leaflet documents the latest research in this field and provides well-referenced recommendations for health practitioners. "The Australian National Physical Activity Guidelines recommend that adults take at least 30 minutes of moderate-intensity PA each day. Over half of Australian adults do not reach these recommended levels of PA and the consequences of physical inactivity account for 7% of the total disease burden in Australia."

Other topics covered in this PHCRIS Research Roundup series have included
Chronic disease self-management, Dementia and primary health care, The primary care role for people with cancer, Improving access to rural health care, Researching patient & family experience and A new climate for Indigenous health

Tips for parents on limiting video game and computer use by their children

"TV, interactive video games, and the Internet can be excellent sources of education and entertainment for kids. But too much screen time can have unhealthy side effects. That's why it's wise to monitor and limit the time your child spends playing video games, watching TV, and playing games on the internet. The American Academy of Pediatrics (AAP) recommends that kids under age 2 have no screen time, and that kids older than 2 watch no more than 1 to 2 hours a day of quality programming." The Nemours Foundation has tips for limiting time spent on these activities. (From: Healthfinder 18th October and Nemours Foundation website)

Health expenditure in Australia 2007-2008

This new report from the Australian Institute of Health & Welfare found that Health expenditure in Australia in 2007-08 reached $104 billion. As a percentage of GDP it was 9.1%, the same level as in 2006-07. The area of health expenditure showing the highest growth was public health expenditure which grew by 21% in real terms, mostly due to extra spending on immunisation. Health expenditure Australia 2007-08 examines expenditure on different types of health goods and services in the decade to 2007-08. It describes funding by the Australian and State governments, private health insurance and individuals; compares health expenditures in the different states and territories and compares Australia's spending with other countries.

Does improving quality save money?

A newly published report from Britain is titled: Does improving quality save money? : A review of evidence of which improvements to quality reduce costs to health service providers.

In it, Dr John Øvretveit reviews the evidence of whether improving quality can also save money for health service providers. It explores the cost saving potential of initiatives to improve quality and the barriers to success. "For most of the last decade, organisations have become accustomed to times of plenty. But the impending public sector spending crisis changes this context utterly. There are many ways in which savings can be made. The report sets out to answer whether improving quality can also help to address the need for costs to be saved." The evidence suggests that improving quality could have an important if limited contribution to addressing financial pressures.

Assisted reproductive technology in Australia and New Zealand

In 2007, there were 56,817 assisted reproductive technology (ART) treatment cycles undertaken in Australian and New Zealand. Of these cycles, 17.4% resulted in a live delivery (the birth of at least one liveborn baby). In total, 10,856 liveborn babies were born following ART treatment undertaken in 2007. The most important recent trend in ART treatment has been the reduction in the rate of twins and triplets births, with the multiple delivery rate falling from 18.7% in 2003 to 10.0% in 2007. This trend has been associated with an increase in the proportion of ART treatment cycles using single embryo transfer, from 32.0% in 2003 to 63.7% in 2007.

http://www.aihw.gov.au/publications/index.cfm/title/10753

Mothers and the child protection system

Inappropriate intervention in child protection cases has left many parents, especially mothers, feeling bewildered, confused and distrustful of the system, new UQ research suggests.
The research, conducted by Associate Professor Heather Douglas and Dr Tamara Walsh from UQ’s TC Beirne School of Law, has found that parents experiencing poverty and domestic violence are often targeted for intervention by child protection departments but that child protection workers do not have the skills or resources to support families.As a result, some children may be unnecessarily removed from their parents.
Douglas H, Walsh T & Blore K,

http://www.law.uq.edu.au/uq-research-provides-insight-into-child-protection

Internet addiction linked to ADHD, depression in teens

Story Highlights:

* Study found boys were at a higher risk of Internet addiction than girls
* Doctor: Treatment for addiction cannot involve simply abstaining from the Internet
* Internet addiction may be not as widespread in the U.S. as in Asian countries
* It could become one of the most chronic childhood diseases in America, doctor says

Read the whole story: http://www.cnn.com/2009/HEALTH/10/05/depression.adhd.internet.addiction/

PubMed® Redesign

The US National Library of Medicine is pleased to announce a redesign of the PubMed interface. While retaining the robust functionality, the interface was simplified to make it easier to use while promoting scientific discovery. The PubMed homepage has been streamlined, requiring less effort to find resources. The new homepage includes an NCBI Header, Search Bar, and Footer that are common to all PubMed pages. Additional useful features are outlined in the NLM Technical Bulletin 2009 September-October No 370. (From: NLM New files for the week of Sep 28, 2009)

CDC Links Infections With Swine Flu Deaths

WEDNESDAY, Sept. 30 (HealthDay News) -- Bacterial co-infections are common among people who have died of H1N1 swine flu in the United States and probably contributed to their deaths, according to a new federal government study. Researchers from the U.S. Centers for Disease Control and Prevention analyzed lung tissue samples from 77 people who died of H1N1 flu between May and August this year and found bacterial co-infections in 22 of them (29 percent), including 10 caused by common bacteria called Streptococcus pneumoniae, or pneumococcus. Multiple pathogens were a factor in four of the cases, the CDC said. The findings were published Sept. 30 in an early release of the CDC's Morbidity and Mortality Weekly Report. The study highlights how important it is for people to get vaccinated against pneumococcus, the researchers said. (From: Healthfinder 1/10/09)

New reviews of surgical procedures

The Australian Safety and Efficacy Register of New Interventional Procedures - Surgical (ASERNIP-S), conducts systematic literature reviews on the safety and effectiveness of new surgical techniques. They also conduct clinical and research audits or studies, identify and assess new and emerging techniques, and provide input into the production of clinical practice guidelines. The latest reviews published by ASERNIP-S include:
Systematic literature reviews
• Permanent and semi-permanent dermal fillers

• The effect of fatigue on surgeon performance

• Treatments for varicose veins
Rapid reviews

• Clinical treatments for wrist ganglia

• Diagnostic arthroscopy for conditions of the knee

• Male non-therapeutic circumcision

• Treatments for varicose veins

• Upper airway surgery for the treatment of adult obstructive sleep apnoea

The full range of ASERNIP-S reviews is accessible through the publications page of ASERNIP-S on the Australian College of Surgeons website.

Towards national Indicators of Safety and Quality in Health Care

This report sets out recommendations for a set of 55 national indicators of safety and quality of clinical care provided to patients across the Australian health care system. Thirteen indicators apply to primary and community health services, 25 to hospitals, six to specialised health services, and five to residential aged care. Eleven indicators apply to multiple or all types of health services.
The Australian Institute of Health and Welfare suggests that public reporting on these indicators could serve two main purposes: to provide transparency and to inform decision-making about overall priorities and system-level strategies for safety and quality improvement; and to inform quality improvement activities of service providers. The indicators cover the national health priority areas and major burden of disease and injury groups. Download here for free.

Health expenditure Australia 2007-08

Health expenditure Australia 2007–08 is the latest in the Australian Institute of Health and
Welfare’s long-running series of reports on Australia’s National Health Accounts. Health expenditure in Australia in 2007-08 reached $104 billion and as a percentage of GDP it was 9.1%, the same level as in 2006-07. The area of health expenditure showing the highest growth was public health expenditure which grew by 21% in real terms, mostly due to extra spending on immunisation. Health expenditure Australia 2007-08 examines expenditure on different types of health goods and services in the decade to 2007-08. It describes funding by the Australian and State governments, private health insurance and individuals; compares health expenditures in the different states and territories and compares Australia's spending with other countries. Download part or all of the report here.

Faster Detection of TB May Be on the Horizon

FRIDAY, Sept. 25 (HealthDay News) -- A new test can rapidly identify active tuberculosis in people who've had negative sputum tests, say European researchers. In about half of all people with active TB, the disease-causing bacterium can't be identified using sputum tests. Because of this, new diagnostic tests are needed to help control the spread of TB, the researchers said. "In this study, we showed that a differentiation between active pulmonary tuberculosis and [latent TB infection] is possible by the ELISpot test," Dr. Christoph Lange, principal investigator of the Tuberculosis Network European Trials group study, said in a news release from the American Thoracic Society. The study is published in the Oct. 1 issue of the American Journal of Respiratory and Critical Care Medicine.(From: Healthfinder Weekend Health News 27/9)

World Alzheimer Report

On 21 September, World Alzheimer's Day, Alzheimer's Disease International released the World Alzheimer Report 2009, which presents a comprehensive global prevalence study of dementia, looking at levels of mortality, disability, strain on carers and dependency. Frighteningly, the report estimates that 35.6 million people worldwide will be living with a form of dementia in 2010 and that this number is estimated to nearly double every 20 years, to 65.7 million in 2030, and 115.4 million in 2050.

The report also offers examples of good national dementia plans and information on health service responses. It includes eight recommendations that will provide a global framework for action on dementia, the first of which is that The World Health Organization (WHO) should declare dementia a world health priority.

Cardiovascular risk factors and life expectancy

The British Medical Journal has just published the results of a major long-term study by Robert Clarke et al, Life expectancy in relation to cardiovascular risk factors: 38 year follow-up of 19 000 men in the Whitehall study .

18 863 men aged 40-69 employed in the civil service in London, were examined in 1967-70 and followed for 38 years. 13 501 have died and 4811 were re-examined in 1997. At entry, 42% of the men were current smokers, 39% had high blood pressure, and 51% had high cholesterol. Even though these risk factors changed over time (for example, many gave up smoking), baseline differences in risk factors were associated with 10 to 15 year shorter life expectancy from age 50.

Paediatric Emergency Guidelines

A statewide, web-based, Paediatric Clinical Practice Guidelines e-learning package, based on the 12 current guidelines, has been launched. The interactive modules promote as well as test understanding of the key clinical principles behind the CPGs and also facilitates monitoring of the clinician engagement across the health system.

The package is available here online and enables access from anywhere in the state by internet or local intranet. It is free to register.

WHO Issues Guidelines for Antiviral Treatment of H1N1 and Other Influenza

The new guidelines published on 20th August are titled "WHO Guidelines for Pharmacological Management of Pandemic (H1N1) 2009 Influenza and other Influenza Viruses". The purpose of the new recommendations is to provide a basis for advice to clinicians regarding the use of the currently available antivirals for patients presenting with illness caused by influenza virus infection, as well as considerations regarding potential use of these antiviral medications for chemoprophylaxis. (From: Medscape News CME dated 19th September 2009)

Women’s Health Topics

A new website has been launched on the US National Library of Medicine site as part of the Specialized Information Services Website. It lists Women's Health Resources - covering the following Women’s Health Topics: General topics; Alcohol, Tobacco and Substance Abuse; Autoimmune Diseases; Bone and Joint Health; Cancer; Complementary and Alternative Medicine (CAM); Diabetes; Exercise and Fitness; Heart Disease; HIV/AIDS; Menopausal Hormone Therapy; Mental Health; Nutrition; Reproductive Health; Safety and Wellness; Sexually Transmitted Diseases (STD); Violence and Abuse (From NLM Weekly Announcements for the week beginning 14th September 2009)

Top 10 Internet Search Tips

Melissa S. Barker, author of Internet Research Illustrated 5th Edition, has listed her top 10 tips to search the internet.
The invisible or deep Web is the vast reservoir of information stored in databases, estimated to be 500 times larger than the visible web and inaccessable to search engines. Find ways with this 5 page summary to improve your searching.

OncologySTAT

If you need to keep up with latest oncology information, use OncologySTAT to stay current, save time and make informed evidence-based decisions. Sign up for free and have a look at some of the following features.

• 29 Cancer-type spotlights, allowing all content for a specific cancer to be easily accessed from a single page
• Journal Scans: Concise summaries of the most important articles from the leading cancer journals, as selected by our expert editors
• Free full-text access to recent articles from over 100 Elsevier cancer-related journals
• Daily professional news stories
• Dedicated Review Article section

Screening on SBS by the Rural Health Education Foundation

SBS Television will be broadcasting three Rural Health Education Foundation documentary programs on the following dates:

It Takes a Village - Monday 28 September at 5.30pm

Stay Strong - Monday 5 October at 5.30pm

Strong and Deadly - Monday 12 October at 5.30pm

These 3 programs focus on community development and Aboriginal and Torres Strait Islander Health.

The Foundation's live Type 2 Diabetes Mellitus (T2DM) Four-part Guidelines Television series continues on September 22nd, October 13th and November 10th.

The series is available as a free CD-Rom set to Australian health professionals. Contact the RHEF on their website or email rhef@rhef.com.au .

Antibiotics Bought Easily on the Internet

TUESDAY, Sept. 15 (HealthDay News) -- Consumers who decide on their own that they need antibiotics can easily find and buy the medications on the Internet, without the benefit of a prescription, new research shows. The practice is illegal, the study authors said, and could contribute to an overuse of antibiotics that is known to create resistant bacteria which, in turn, can cause life-threatening infections. One expert agreed the trend has troubling implications.

"The expanded and uncontrolled use of antibiotics is a public health hazard because of the impact on creating multiple drug-resistant bacteria," said Dr. Robert Schwartz, chair of the department of family medicine and community health at the University of Miami Miller School of Medicine. "We already have a problem in our country with physicians overprescribing antibiotics . . . Allowing individuals in society unrestricted access to antibiotics is a set-up for a public health disaster." Most previous research and attention has focused on overprescribing by doctors, said Arch G. Mainous III, lead author of a paper appearing in the September/October issue of the Annals of Family Medicine. "Unfortunately, it's misleading to make the assumption that that's only where antibiotics are available," he noted. "Consumers should consult with their primary-care providers first before ordering antibiotics and ask for advice," Schwartz recommended. "Many people will take antibiotics for viral infections, which of course are useless and have potential negative side effects -- destroying normal gut flora, allowing potentially harmful bacteria that are stable under normal conditions to become pathogenic or harmful. They should save their money." (From Healthfinder 16/9/09)

University of California, San Francisco: Drug Industry Document Archive

This archive is one that will be of particular importance to those with an interest in public health, public policy, and the general activities of pharmaceutical companies. The Drug Industry Document Archive (DIDA) was created by the University of California, San Francisco (UCSF) and it contains over 1500 documents related to pharmaceutical industry clinical trials, publication of study results, pricing, marketing, and relations with physicians. Many of these documents were previously secret, and were only made public as a result of lawsuits filed against a number of prominent pharmaceutical companies. First-time visitors may wish to start by clicking on "The Documents" link on the homepage. Here they can read about some of the crucial lawsuits that generated the documents featured in this archive. [KMG] (From The Scout Report via ALIAHealth elist)

Diabetes Type 2 Guidelines

The NHMRC has recently released four new guidelines for Type 2 Diabetes:

• National Evidence Based Guideline for Diagnosis, Prevention and Management of Chronic Kidney Disease in Type 2 Diabetes
• National Evidence Based Guideline for Case Detection and Diagnosis of Type 2 Diabetes
• National Evidence Based Guideline for Patient Education in Type 2 Diabetes
• National Evidence Based Guideline for Blood Glucose Control in Type 2 Diabetes

The Diabetes Australia website has several more best practice guidelines for health professionals.

Chocolate is good for your heart

An 8-year study published in the Journal of Internal Medicine this month by Imre Janszky, et al. has strongly linked chocolate consumption two or more times weekly to 66% less risk of dying from heart disease.

Chocolate consumption and mortality following a first acute myocardial infarction: The Stockholm Heart Epidemiology Program was a population-based inception cohort study, following 1,169 non-diabetic patients hospitalized with a confirmed first acute myocardial infarction and self-reporting of chocolate consumption over time. While chocolate consumption had a strong inverse association with cardiac mortality, the eating of other sweets had no statistical bearing on any type of mortality. The researchers conclude that "confirmation of this strong inverse relationship from other observational studies or large-scale, long-term, controlled randomized trials is needed."

The hidden cost of genetic screening

Is uptake of genetic testing for colorectal cancer influenced by knowledge of insurance implications? MJA 2009; 191 (5): 255-258.
Louise Keogh has authored this study, which looks at the causes of colorectal cancer. It found that people are choosing not to obtain genetic information because of how it will affect their eligibility for insurance, despite the fact that early screening can prevent cancer from progressing.

Emergency services and legal implications after Katrina

Strained by Katrina, a Hospital Faced Deadly Choices by Sheri Fink was published in the New York Times Magazine recently. This is the story of an emergency doctor and the nurses assisting her who were arrested after allegedly euthenasing some gravely ill patients when their hospital was completely stranded by Hurricane Katrina. The doctor, Anna Pou, has since helped write and pass three laws in Louisiana that offer immunity to health care professionals from most civil lawsuits — though not in cases of willful misconduct — for their work in future disasters, from hurricanes to terrorist attacks to pandemic influenza. In this article, Fink uncovers new evidence which suggests that 17 patients were killed by Pou and that she still has many questions to answer.
A fascinating read for anyone interested in emergency preparedness, altered states of care and medical immunity.

Exhausted Australian doctors told to drink more coffee

Exhausted doctors in Australia's northeastern state of Queensland have been advised by the government to drink more coffee.

A 102-page "fatigue management strategy" developed by Queensland Health, has recommended that the "strategic use of caffeine" could be beneficial to extremely tired doctors.
The document suggested medics should consume 400 milligrams of caffeine, which is equivalent to six cups of coffee, to stay awake on the job.
As such a high coffee intake was "not always feasible or realistic", the report said doctors could take caffeine tablets or energy drinks as an alternative.
"Compared with other psychoactive drugs, for example, modafinil (a prescription-only narcolepsy treatment), caffeine is supported in its use as it is more readily available and less expensive," the document said.
The recommendation comes after 88 per cent of doctors in a survey of 113 state hospitals said they experienced dangerous fatigue while working.
A union representing Queensland doctors also warned that public hospital patients were dying because dangerously tired medics were being forced to work up to 80 hours without a break.
However, the suggestion that coffee was the solution to the staffing crisis has been greeted with disdain by Australian doctors.
Susannah McAuliffe, of Salaried Doctor's Queensland, said the strategy was "absolutely ridiculous" and would put patients in further danger.
Andrew Pesce, chairman of the Australian Medical Association, said the real answer to fatigue management was sensible rostering.
"It would be hard for me to be convinced that caffeine that makes you feel less tired is going to necessarily improve your performance," he said.
"I think at the end of the day, we should be focusing on a fundamentally safe rostering system and an acknowledgement that certain minimum number of hours of sleep is what is necessary to maximise performance."
Paul Lucas, Queensland's health minister, said the state was aiming to train more doctors and cap hospital shifts at 12 hours over the next two years, but had no immediate solution to fatigue and staff shortages.
"If the doctors are not there, we can't do it," he said. "We can't say we'd rather not have it as it is and create doctors out of the air."
Australia's federal government is currently under pressure to seize control of the nation's ailing public hospital system, which is currently managed by state governments.
Kevin Rudd, the prime minister, made repairing the health system a campaign promise in 2007 and has warned that a full takeover of public hospitals was still on the cards.

Let Orthopedic Surgery Wait Until Morning When Possible

MONDAY, Sept. 7 (HealthDay News) Scheduling a prime daytime slot to undergo an orthopedic procedure may lower your risk of an unplanned follow-up surgery later on, a new study has found. The study, published in the September issue of The Journal of Bone and Joint Surgery, found little difference otherwise for healing, recovery time and major complication rates between certain orthopedic surgeries done during the day (between 6 a.m. and 4 p.m.) and those done after hours (4 p.m. to 6 a.m.). "Although everyone wants to be treated immediately, it may be in a patient's best interest to wait until morning. The reality is that the on-call night surgical team may not be well rested, as it is likely they had just finished a normal day shift," study lead author Dr. William M. Ricci, chief of the Orthopaedic Trauma Service at the Washington University School of Medicine in St. Louis, said in a news release issued by the American Academy of Orthopaedic Surgeons. (From: Healthfinder Sept 7, 2009)

Sleep Apnoea Raises Risk of Death, Especially for Men: Report

Sleep-disordered breathing is a common condition associated with adverse health outcomes including hypertension and cardiovascular disease. The overall objective of this study was to determine whether sleep-disordered breathing and its sequelae of intermittent hypoxemia and recurrent arousals are associated with mortality in a community sample of adults aged 40 years or older. Sleep-disordered breathing is associated with all-cause mortality and specifically that due to coronary artery disease, particularly in men aged 40–70 y with severe sleep-disordered breathing. Punjabi and his colleagues published their findings in the August 18 issue of PLoS Medicine . (From: Healthfinder 19/8/09)

Josie's Story Teaches Hospitals How to Become Safer

Almost 10 years ago, the healthcare industry found that it might not be as safe as it thought. It was then that the Institute of Medicine released To Err Is Human, which noted that each year a million or more hospitalized patients are injured and as many as 98,000 die as a result of errors in their care.

Janice Simmons, for HealthLeaders Media, September 3, 2009

Read the whole article: http://www.healthleadersmedia.com/content/238442/topic/WS_HLM2_QUA/Josies-Story-Teaches-Hospitals-How-to-Become-Safer.html

Disaster Glossaries on the US National Library of Medicine Website

Standard and concise disaster terminology for all members of the disaster risk reduction and emergency management community enables professionals to collaborate effectively. Professionals need to be able to find and access different disaster-related glossaries as a step toward creating more uniform terminology, especially for use in international disaster research and publications. This list of glossaries may be helpful in developing a scholarly consensus on such disaster and emergency terms. (From the NLM Weekly Announcements)

Updated Files on the National Library of Medicine Website

MedlinePlus, part of the US National Library of Medicine, has some updated Health Topics which may be of interest. (From the NLM Weekly Announcements)

*MedlinePlus: Amyloidosis
http://www.nlm.nih.gov/medlineplus/amyloidosis.html
*MedlinePlus: Tongue Disorders
http://www.nlm.nih.gov/medlineplus/tonguedisorders.html
*MedlinePlus: Intestinal Obstruction
http://www.nlm.nih.gov/medlineplus/intestinalobstruction.html
*MedlinePlus: Hair Loss
http://www.nlm.nih.gov/medlineplus/hairloss.html

Australian e-Journal for the Advancement of Mental Health

The latest issue of the Australian e-Journal for the Advancement of Mental Health is now online
Volume 8, Issue 2 (August 2009) www.auseinet.com/journal/ . There is an Editorial: On remembering and forgetting in prevention (Graham Martin, Editor in Chief); A Guest Editorial: Mental wellbeing of older people: making an economic case (Martin Knapp); A Guest Editorial: Mental health promotion, Australian policy, and housing for people with mental illness (Sam Battams); and various other articles on mental health issues. (From ALIAHealth elist)

Early Onset Dementia broadcast

Today's episode of the Health Report on ABC's Radio National was called Younger Onset Dementia and was a frightening look at how difficult this form of dementia can be for families, and how hard it is for nursing homes to accommodate young, physically strong residents.

"Dementia is not inevitable as you age, but it becomes increasingly common the older you get. However, in some rare cases dementia can occur in people at the age of 40, 50 or 60. In this program Lynne Malcolm speaks with a 74-year-old woman who is caring for her 56-year-old daughter who has a memory span of just two minutes; and with a neuroscientist who explains younger onset dementia, why it occurs, what the early signs are and how to treat and cope with the disease."
Click here to download a podcast, to listen online or to read a transcript of the program.