MNCLHD

MNCLHD

Friday, November 30, 2012

World Aids Day

1 December is World AIDS Day for 2012.  This year's theme is "HIV is still here". The World AIDS Day website is useful for lots of up to date information on the disease, including the fact that although the number of new HIV diagnoses in Australia has been stable for the past five years, there were still 1137 new infections diagnosed in 2011, an increase of 8.2% from 2010.

A useful article on recent global trends in HIV/AIDS was published this year in the journal AIDS.  "The evolving epidemiology of HIV/AIDS" by de Cock and others describes the challenge of the epidemic, with about 34 million people living with HIV worldwide, and nine countries in southern Africa accounting for less than 2% of the world's population representing about one third of global HIV infections.  Ask at your health library for a copy of the full text of the article.
AIDS 26 (10), 19 June 2012 : 1205-13.  

International profiles of health care systems

International Profiles of Health Care Systems: Australia, Canada, Denmark, England, France, Germany, Japan, Iceland, Italy, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United States has been published by the Commonwealth Fund.

Each overview covers health insurance, public and private financing, health system organisation, quality of care, health disparities, efficiency and integration, care coordination, use of health information technology, use of evidence-based practice, cost containment, and recent reforms and innovations.  Summary tables compare overall results on such factors as health care spending, hospital utilisation, patient safety, disease prevention and public views. 

Patient experiences 2011-12

The Australian Bureau of Statistics conducts a Patient Experience Survey annually, collecting national data on the access and barriers to health services such as general practitioners, medical specialists, dentists, pathology tests and hospital experiences.  Patient experiences in Australia: summary of findings 2011-12 is the latest report.

Overall levels of satisfaction with health professionals was high, with around 80% of people reporting that they always or often felt that they listened carefully, showed respect or spent enough time with them.  Dental professionals scored particularly well.

Changes in life expectancy 1998-2009

This report, Changes in life expectancy and disability in Australia 1998-2009 from AIHW shows that older Australians are living longer without severe or profound limitations in their daily activities.  However, the ageing of the population is leading to a larger number of people with disability and activity limitation. 

From 1998-2009, life expectancy at birth rose from 75.9 years to 79.3 years for males and from 81.5 years to 83.9 years for females.  Boys born in 2009 could expect to live an average 61.1 years without disability (girls 64.3), and another 17.7 years with disability (girls 19.6), including 5.5 with severe or profound activity limitation (girls including 7.5 years with severe or profound activity limitation.

Thursday, November 29, 2012

Science of immunisation - Q and A

The Australian Academy of Science has released "The Science of immunisation : questions and answers" in an attempt to address "confusion created by contradictory information in the public domain."  It explains the current situation in the science of immunisation, including where there is scientific consensus and where there is uncertainty.  The document discusses the meaning of the words vaccine and immunisation, and discusses the benefits and the safety of vaccines.

The publication was endorsed by the Royal Australasian College of Physicians and the Australian Medical Association.

Childhood injury trends report

Trends in hospitalised childhood injury in Australia 1999-07 is a report just released by the AIHW providing summary data on trends in three age groups: 0-4, 5-9 and 10-14 for each year of the study.  Almost half a million children were hospitalised as a result of an injury during this period, with boys outnumbering girls by 2 to 1.

Falls were the main cause of hospitalised injury, and transport-related injuries were also common.  The only category where girls outnumbered boys was in intentional self-harm (3,514 girls being hospitalised for this and 837 boys.) 

Learning Guide for allied health professionals


HETI (Health Education & Training Institute) has produced The Learning Guide : a handbook for allied health professionals facilitating learning in the workplace.  "It provides information and guidelines based upon published evidence that supports effective methods of promoting education, learning needs and professional development of allied health professionals working in clinical settings, to contribute to the safey and quality care of patients."

The Learning Guide follows the earlier production by HETI of The Superguide - a handbook for supervising Allied Health professionals.

Impact of work hours on Australia's health

An unhealthy obsession? The impact of work hours and workplace culture on Australia's health is a new report from the Australia Institute.  According to authors Denniss and Baker, Australians work some of the longest hours in the developed world.  For many of us, our work-related stress is due more to the mismatch between desired and actual hours at work, rather than the number of hours worked.  Australian workers would also be happier if there was more flexibility in their work arrangements, and this is true for workers across the earning spectrum. 

More than 3.2 million Australians report that their working conditions are a cause of stress and anxiety, 2.9 million have experienced a loss of sleep as a result of their working arrangements and 2.2 million Australians report that their work has an adverse impact on their personal relationships.

Wednesday, November 21, 2012

Workplace barriers for people with hearing loss

Labour force activities, barriers and enablers for people with a hearing loss : the workforce barriers and incentives study has just been published by the Australian 
  • Centre for Economic Research on Health.  It considers, by way of survey, 
  • the problems that people who want to work confront when they have a hearing loss. The results indicate that some of those barriers can be overcome by support in the workplace from colleagues and access to appropriate equipment and support services.
    The report concludes, "Measures that remove or ameliorate the barriers that people with a hearing loss currently face present an opportunity to improve participation rates and hours worked in this subpopulation. This is likely to be particularly important as the working age population itself ages and the prevalence of hearing loss grows in the working age population."

    Perioperative management of HIV infected patients

    Perioperative Management of HIV Infected Patients is a recently released guideline from the New York State Department of Health.  Some of the considerations when formulating the guideline were the risk to the surgical team, as well as pre and postoperative assessment of hepatic and renal dysfunction, coronary artery disease and cardiac risk, coagulopathy, thrombocytopenia, and neutropenia, active alcohol or substance use, history of prior infection with MRSA, and any drug allergies the patient may have.

    Health workforce 2025


    Health Workforce 2025 (HW 2025) provides Australia’s first major, long-term national projections for the health workforce out to 2025.  Volumes 1 and 2 dealt with doctors, nurses and midwives, while Volume 3 examines individual medical specialties in Australia.  The reports found that reform is essential to ensure a sustainable, affordable health workforce for the future.   

    Several key projections were made that indicate problems if no changes take place by 2025.  These include a highly significant shortage of nurses, a shortage of doctors, a shortage of postgraduate medical training places, and an uneven distribution of the medical workforce across Australia.  Issues raised in Volume 3 included the fact that although the number of medical specialists is increasing, the workforce is not evenly distributed, and there are not enough generalists.  Psychiatrists and Radiation Oncologists are the most at-risk specialties.


    Friday, November 16, 2012

    Antibiotic Awareness Week

    Antibiotic Awareness Week has been promoted globally this week as an initiative aimed at combating the development of  antibiotic resistance, which is an enormous health threat.  If you work in NSW Health you would be aware of the Clinical Excellence Commission's drive this week in "Quality Use of Antimicrobials in Healthcare".

    The Australian Commission on Safety and Quality in Healthcare also provides some good information on Antibiotic Awareness Week on their website, highlighting concerns about inappropriate use and overuse of antibiotics.

    For a simple summary on superbugs, antibiotics and resistance, we recommend the ABC's Health and Wellbeing page, "What are superbugs?".

    Journal issues on vaccination and infectious disease

    Two journals have this month published special issues on vaccination and the control of infectious disease.  Both are open access, so all articles are freely available.

    Clinical Microbiology and Infection has a supplement, The Impact of Vaccines on Public Health.  Review articles in the supplement are divided into the History of Vaccination, Pneumococcal Disease, Vaccination against Viral Diseases, Vaccination in Specific Situations and Future Directions for Vaccination.

    International Nursing Review has published a virtual issue, The Prevention of Infectious Diseases and their Consequences : still a policy priority for nurses.  There are eight articles here, covering such issues as the papillomavirus vaccine, influenza, diarrheal disease, MRSA, hepatitis and occupational exposure to HIV.

    Clinical Microbiology and Infection, Oct 2012 18 (Suppl s5) : 1-122.
    International Nursing Review, virtual issue, October 2012.

    Meta Analysis of Hospital in the Home

    A meta-analysis of “hospital in the home” has been published this month in the Medical Journal of Australia by Caplan and others.  The paper analysed 61 randomised controlled trials comparing HITH care with in-hospital treatment for patients over 16 years of age. The authors report that HITH care led to reduced mortality, readmission rates and cost and that patient satisfaction was higher in HITH in 21 of 22 studies, and carer satisfaction was higher in six of eight studies where this was examined.

    Medical Journal of Australia 2012;197(9):518-519. (Open access)

    Nursing and multiple sclerosis - Guideline

    The American Association of Neuroscience Nurses has just published a new guideline:  Nursing Management of the Patient with Multiple Sclerosis.

    Prescriptions for obstructive airway disease - AIHW report

    Medications prescribed for people with obstructive airways disease: antibiotics and inhaled corticosteroids, is an AIHW report which focuses on the appropriate use of certain medications for the management of obstructive airways disease, including asthma and chronic obstructive pulmonary disease (COPD). Appropriate use of medications is important in maximising health benefits for patients, minimising the negative effects of medications, and controlling health costs.  

    Data in this report suggest that antibiotics are commonly used among patients with asthma and COPD, and that supply patterns for inhaled corticosteroids are often not consistent with treatment guidelines for the management of these conditions.

    Heat and climate change implications for health

    Socio-cultural reflections on heat in Australia with implications for health and climate change adaptation is a paper from Jane Dixon and others at the National Centre for Epidemiology and Population Health.  The authors explored ways in which vulnerable sub-populations adapt their personal behaviour to cope with heat.
    The warm climate of Australia and the increase in heat related deaths indicates that Australians need to be better prepared for coping with extreme heat. A number of methods of dealing with heat were discussed in the paper, but it seemed that the reliance on air conditioning was universal, which itself contributes to carbon emissions and thus fostering climate change conditions such as further heatwaves.

    Thursday, November 08, 2012

    Ageing in the 21st Century - UN Report

    Ageing in the Twenty-First Century : A Celebration and A Challenge is a landmark publication from the United Nations Population Fund and HelpAge International.  It represents a collaboration of over 20 United Nations entities and major international organizations working in the field of ageing and reviews policies and action taken by governments and other stakeholders since the Second World Assembly on Ageing in 2002. In addition to providing many inspiring examples of innovative programs that address population ageing and the concerns of older persons, the report captures the voices of some 1300 older persons themselves.

    The report concludes with ten priority areas for maximising the opportunity of ageing populations, including the need to recognise the inevitability of ageing populations and to ensure all stakeholders are adequately prepared for the growing number of older persons.

    When is medical treatment futile? ABC Health Report

    Many doctors want to lift the lid on a phenomenon they say is worsening the suffering of many dying Australians. It's called 'limited benefit' or 'futile medical treatment', where patients with a poor prognosis are given aggressive drug therapy or surgery.  This special edition of ABC Radio National’s Health Report opened debate on this issue, and the possibility that many specialists are not considering palliative care early enough.

    Dr Peter Saul, Senior Intensive Care Specialist and Ethical Consultant with the New South Wales Health Department discussed the problem of initiating a conversation with dying patients which includes “'do you really want us to do all of this and have you spoken to your family and what were your expectations' [which] becomes a very long conversation, whereas the 'sign here, we're going to operate' is five minutes.”   He believes that doctors don’t always tell patients the full story, but that they mean well and are not solely responsible for the problem of aggressive treatment being given to uninformed, dying patients.  “My own personal view is that Australia is a very, very death-denying society and that this discourse doesn't take place very much.”

    Dr Steve Hambleton, President of the AMA, agreed to a certain extent, "When we present options to patients there is a tendency to ... talk about the people who do survive, not really about the reality  So we do tend to put things in a very optimistic way and we need to be realistic, and some people are going to reach that long tail, the survival tail, but the majority won't."  

    The program includes interviews with other specialists, including those in palliative medicine, and also covers the legal and ethical viewpoints on this debate.  The link above will take you to the transcript or podcast, or you can listen online.

    Workplace screening programs for chronic disease prevention

    Workplace screening programs for chronic disease prevention : a rapid review has just been published by Bill Bellew and others at the University of Sydney for the Sax Institute.  The authors used evidence retrieved from the main databases of biomedical and health economic literature published to March 2012, supplemented with relevant reports and they found strong evidence of effectiveness of HRAs (when used in combination with other interventions) in relation to tobacco use, alcohol use, dietary fat intake, blood pressure and cholesterol.  They also found sufficient evidence for worksite programs to control weight issues.  They concluded that these programs had a favourable impact on the use of healthcare services and financial return for the employer.   

    Drinking cultures and social occasions report

    Drinking cultures and social occasions : alcohol harms in the context of major sporting events, published by VicHealth, explores this subject in terms of general patterns, gender patterns and age patterns. A range of alcohol-related harms were considered, including acute intoxication requiring medical attention, assaults, and motor vehicle accidents.  
    The peak months of the year for ambulance attendances, emergency department presentations, and hospital admissions attributed to acute alcohol intoxication were November and December, with February also being identified as a peak month among males. Consistent with the literature, varying effects were noted for major sporting events. For all groups examined, elevated cases of alcohol intoxication occurred on the day of the Melbourne Cup, and also for all groups except females on the day of the AFL Grand Final and the event of the Commonwealth Games. Numbers of ambulance attendances for acute intoxication were significantly lower than expected on the day following the Melbourne Cup for all patients, and this was driven by the trend among females.

    Friday, November 02, 2012

    ‘It’s been a long hard fight for me’: the Stolen Generations and Narratives of Poor Health in Australia 1883-2009

    Health, according to the World Health Organisation (WHO), can be defined as ‘a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity.’ Using this definition of health, and others, as guiding principles, this thesis, by Lisa Vicki Campbell of the University of Waikato in Hamilton, New Zealand, takes a thematic approach in order to demonstrate how nineteenth and twentieth-century Australian government policies have influenced the health of Indigenous Australians today.

    The four key themes investigated are alienation, mental illness, alcohol abuse, and crime. By weaving the narratives taken from a number of published oral interviews, testimonies from various Australian reports, and other edited collections, this thesis argues that from the perspective of numerous members of the Stolen generations, the forcible removal of Aboriginal children and the subsequent feelings of alienation produced by removal, have had significant and on-going implications for the current state of poor health within Aboriginal and Torres Strait Islander communities. (APO 29/10/12)

    The Menzies Nous Australian Health Survey 2012

    The Third Biennial National Survey conducted by the Menzies Centre for Health Policy and Nous Group (Nous) has been published, providing key findings about the views held by Australians on their own health, on the Australian healthcare system, and aged care services. Previous surveys were conducted in 2008 and 2010.The Australian Health Survey 2012 was conducted via a phone interview of 1200 people in July 2012. Interviews were conducted by telephone using random digit dialling Computer Assisted Telephone Interviewing (CATI).To enable analysis of trends since 2008, a number of questions regarding the health of Australians and use of the health care system were consistently asked in 2008, 2010 and 2012. To reflect changes in the health care system, some minor amendments and refinements were made to these questions in the 2012 survey.  A number of questions were also asked for the first time this year – particularly those regarding Australian perspectives of the aged-care reforms. Data from all surveys have been post-weighted by age, sex, state and education to reflect the population distribution.

    Thursday, November 01, 2012

    Australian Health Survey - first results

    The first results released by the Australian Bureau of Statistics from the Australian Health Survey 2011-12 have some good and bad news; smoking rates continue to fall, as do rates of drinking at risky levels, but the number of people who are overweight and obese continues to rise.
    The proportion of overweight adult Australians has increased to the point where almost 63% of the population are now classified as overweight or obese.  70% of men, 56% of women and 25% of children are overweight or obese.  Results released this week from the Australian Health Survey are the first in a series of results that will be release progressively over the next 18 months
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    Picture of Australia's children 2012


    A picture of Australia's children 2012 provides the latest information on how Australia is faring according to key indicators of child health, development, and wellbeing. Deaths rates for infants and children have declined since 1986, rates of risky drinking and smoking among children aged 12-14 are down, and most children achieve above the minimum standards for reading and numeracy.

    But there is still room for improvement. Almost one-quarter of children are developmentally vulnerable at school entry, and Aboriginal and Torres Strait Islander children and children in socioeconomic disadvantaged areas are likely to fare worse across a broad range of indicators

    Measuring the quality of allied health services in Australia

    'Measuring the quality of allied health services in Australia: Is it a case of "the more we learn, the less we know"?' has recently been published in the Journal of Healthcare Leadership.
    This evidence-informed analytical review outlines factors that should be considered by allied health leaders when measuring allied health service quality.  It describes allied health services in detail and discusses the difficulties when making these measurements, taking into account the locations and range of services provided and the complexity of the allied health discipline-mix. The authors emphasise the importance of strong, visionary, and collaborative leadership to ensure that allied health activities and outcomes are both measured and reported in an effective and efficient fashion.

    Grimmer-Sommers K, Milanese S, Kumar S. (2012). Journal of Healthcare Leadership, 4, 71-81

    Assisted reproductive technology report


    Assisted reproductive technology in Australia and New Zealand 2010 has been released by the AIHW.  The report indicated that in 2010, there were 61,774 assisted reproductive technology (ART) treatment cycles performed in Australia and New Zealand. Of these, 23.9% resulted in a clinical pregnancy and 18.1% in a live delivery. There were 12,056 liveborn babies following ART treatments in 2010.  A continuing trend in ART treatment in Australia and New Zealand has been the reduction in the rate of multiple birth deliveries, achieved by clinicians ad patients shifting to single embryo transfer.