Online bipolar screening tool

6% of Australians are affected by bipolar disorder. UNSW researcher Professor Gordon Parker, based at the Black Dog Institute, says that while understanding has increased, bipolar disorder is still frequently under-diagnosed. A significant percentage of people with the condition never receive a diagnosis and, of those who do, the interval from onset of the condition can be 15-20 years.  “Most people with bipolar disorder experience depression and periods of elevated mood - termed mania or hypomania. Such mood swings are often viewed as simply reflecting personality style or clinical depression waxing and waning. Thus, failure to obtain the correct diagnosis can lead to inappropriate or no treatment for a condition that can be brought under control.” Funded by the Department of Health and Ageing, Black Dog Institute researchers have developed and trialled an evidence-based screening self-test to help people identify the likelihood that they might have a bipolar disorder. The self-test is completed by more than 30,000 people/month.

Bipolar Self-Test (Mood Swings Questionnaire - MSQ)

Training to recognise the early signs of recurrence in schizophrenia

The onset of schizophrenia usually occurs during adolescence or early adulthood. Training in early warning signs techniques encourages people to learn, detect and recognise the early warning signs of future illness. Studies indicate that noticing even small changes in signs and symptoms of schizophrenia can often predict future illness and relapse two to 10 weeks later. 
 A recent Cochrane Review compares the effectiveness of early warning signs interventions plus treatment as usual.

Immunisation rates for children in 2011-12

This report from the NHPA allows the public, clinicians and health managers to see the percentages of children fully immunised and how those percentages differ across the country. It reports these immunisation rates for each of the 61 geographic areas covered by the new network of Medicare Locals. The report's findings can be considered in the context of three broad themes: the percentages of children fully immunised and variation between Medicare Local catchments, and between age groups; the numbers of children who are not fully immunised in each Medicare Local catchment; lower immunisation rates among Aboriginal and Torres Strait Islander children.

Read or download the report from the National Health Performance Authority.

Rural Health - 17 Priority Recommendations

The seventeen priority recommendations from the National Rural Health Conference in Adelaide deal with rural and remote aspects of health-related infrastructure, clinical services, health workforce, and improved targeting of programs related to chronic conditions among Aboriginal people and Torres Strait Islanders. The thousand people at the Conference made it clear that they expect their voices and the priority issues to be heard by governments.

Download the recommendations here. 

Hospital surfaces and contamination

The latest special issue of Healthcare Infections showcases a number of articles relating to surface cleaning and environmental cleanliness in Australian Hospitals.One of the main points of these articles is that there is an important role of cleaning in relation to hand hygiene. Contamination of hands can be reduced by daily disinfection of high-touch surfaces.

This special issue titled "Environmental Cleaning" provides a good overview of the role which surfaces play in the transmission of germs, methods to evaluate cleanliness and presents topics related tot he need for cleaning and disinfection.

Healthcare Infection. Volume 18. Issue 1. March 2013 Check with your library for full text access to articles.

Kidney Disease in rural areas

People living in remote and very remote areas of Australia have much higher rates of end-stage kidney disease than their metropolitan counterparts, particularly in younger age groups. Survival rates of patients on dialysis is worse in rural and regional areas than in the major cities.

To raise awareness of this situation, and to assist individuals and organisations to address the needs and develop solutions, the National Rural Health Alliance has partnered with Kidney Health Australia to produce a new Fact Sheet, Kidney disease in rural Australia.

Guidelines for Deactivation of Implantable Cardioverter Defibrillators at the End of Life

Guidelines to assist clinicians to manage ICD deactivation and facilitate a peaceful death for patients at the end of life have now been developed by a Cardiac Network Working Group. In the past it has been difficult for some facilities to organise deactivation of an ICD due to a number of factors including inappropriateness of patient transfer, geographic location or time of day particularly in rural locations. The Guidelines for Deactivation of Implantable Cardioverter Defibrillators (ICD) at the End of Life have been developed using available evidence and in consultation with a range of metropolitan and rural clinicians, consumers, industry representatives and the NSW Ministry of Health.

The Guidelines are available on the publications section of the ACI (NSW Agency for Clinical Innovation) website under Cardiac.

The desire to age in place among older Australians

Many older Australians report a desire to age in place. This AIHW bulletin explores the relationship between this desire and the housing circumstances of older Australians of different tenure types; that is, those who own their home outright, those paying a mortgage and those who rent their home either privately or through social housing.

The bulletin is in two parts: Volume 1 explores how often households move and attitudes towards moving or staying; Volume 2 focuses on the financial circumstances of older Australians in relation to housing and wellbeing. Volume 2 is expected to be released late in 2013.

Hyperglycemia and Blood Sugar

Read about the symptoms, causes, treatment and prevention for over 900 diseases, illnesses, health conditions and wellness issues using MedlinePlus health topics. These topics are regularly reviewed, and links are updated daily. Health Topics is a service provided by the US National Library of Medicine and the National Institutes of Health. Each topic includes clinical trials, research, journal articles and patient handouts.

Two of the new health topics include hyperglycemia and blood sugar. 

Search Engine for Difficult Medical Cases

There are close to 7,000 rare diseases recognized by rare disease organizations. Find Zebra indexes over 31,000 documents covering rare and genetic diseases from 10 reputable sources. FindZebra is a specialised search engine supporting medical professionals in diagnosing difficult patient cases. Rare diseases are especially difficult to diagnose and this online medical search engines comes in support of medical personnel looking for diagnostic hypotheses.

Contrasting red meat study released

In stark contrast to the study in Nature Medicine in our previous blog entry, the summary of a new study in Mayo Clinic Proceedings is entitled, L-Carnitine significantly improves patient outcomes following heart attack : systematic review and meta-analysis.  In this systematic review of controlled trials in 3,629 patients, L-carnitine was found to be associated with significant, or highly significant reduction in all cause mortality, ventricular arrhythmia and the development of angina.

Senior investigator, Carl J. Levie commented, "The Nature Medicine paper is of interest, but the main study reported there was in animals, and unlike our study, lacks hard outcomes."  He also noted that there are various forms of 'carnitine'.  A commentary comparing the two articles can be found on MedPage Today, New Study Questions Carnitine Heart Risk. 

Mayo Clinic Proceedings, Vol 88, Issue 6 (June 2013).  DOI:http://dx.doi.org/10.1016/ j.mayocp.2013.02.007.  For those with access to CIAP, the issue will be available shortly with the article in full text.  

Red meat linked to heart disease in new study

The media this week has been reporting on the latest study linking red meat with poor health outcomes.  Nature Medicine has just published a study linking even lean, unprocessed red meat with heart disease.

In Intestinal microbiota metabolism of L-carnitine, a nutrient in red meat, promotes atherosclerosis by R.A. Koeth et al, researchers studied mice and humans and found that the chemical L-carnitine is associated with the build-up of fatty deposits in blood vessels.  This chemical is also sometimes used as a dietary supplement by body builders and athletes.

Koeth and his colleagues point out that this is an additional issue, alongside the influence of cholesterol in the meat, which may explain why some studies have linked even lean red meat to heart problems.

Contact your health library for the full text of this article: Nature Medicine (2013) doi:10.1038/nm.3145.   

Hospitalisations due to falls by older people, Australia: 2009-10

This report, just published by the Australian Institute of Health and Welfare, estimates that the number of hospitalised injury cases due to falls in people aged 65 and over in 2009-10 was 83,800-more than 5,100 extra cases than in 2008-09.  Women accounted for most of these cases  - as in the previous year, the age-standardised rate of hospitalised fall injuries involving older women exceeded 3,000 per 100,000 population.

About one-third of fall injury cases had injuries to the hip and thigh, and the majority of these were hip fractures. Head injuries accounted for 1 in 5 hospitalised cases and were proportionately more common for men than for women.  As in previous years, the most common cause of injury was a fall on the same level due to slipping, tripping and stumbling, and 70% had occurred in either the home or an aged care facility.

One in every 10 days spent in hospital by a person aged 65 and older in 2009-10 was directly attributable to an injurious fall (1.3 million patient days over the year), and the average total length of stay per fall injury case was estimated to be 15.5 days. These figures are much larger when fall-related injuries are taken into account, so the burden of falls is significant and growing.

Strategic review of medical and health research

The Australian Government this week released its report of the McKeon review, Strategic review of medical and health research : better health through research.  A ten-year plan to better integrate health and medical research into the public health system has been recommended:  “...research must be routinely performed as a part of health-care delivery and there must be greater linkage between health-care providers and research organisations.”

An interesting commentary on the review, "Don't bury the benefits of research to improve the health system" has been written by Stephen Leeder, Director of the Menzies Centre for Health Policy at the University of Sydney. He argues that the vision of the McKeon review is far from the current reality, but that the review "provides an energising view of what could be done".

Making health services adolescent friendly

This guidebook, recently published by the World Health Organisation, sets out the public health rationale for making it easier for adolescents to obtain the health services that they need to protect and improve their health and well-being, including sexual and reproductive health services. It defines ‘adolescent-friendly health services’ from the perspective of quality, and provides step-by-step guidance on developing quality standards for health service provision to adolescents. Drawing upon international experience, it is also tailored to national epidemiological, social, cultural and economic realities, and provides guidance on identifying what actions need to be taken to assess whether appropriate standards have been achieved.

Download Making Health Services Adolescent Friendly here.

Volunteers in health care

Volunteering in health and care : securing a sustainable future is the title of a report from the King's Fund in the UK.  The authors (Chris Naylor et al) look at the important part that volunteers play in improving patient experience, addressing health inequalities, and building a closer relationship between services and communities.  They also outline the changing nature of volunteering and the problems and barriers that can arise. Recommendations include a more strategic approach to the use of volunteers, and the recognition that they should provide added quality rather than a short-term solution to funding issues.

Type 2 diabetes prevalence in Australia by socio-economic status

Ethnic diversity is increasing through migration in many developed countries. Evidence indicates that type 2 diabetes prevalence varies by ethnicity and socio-economic status, and that in many settings migrants experience a disproportionate burden of disease compared with locally-born groups. Given Australia's multicultural demography, the authors of this paper, "Type 2 diabetes prevalence varies by socio-economic status within and between migrant groups: analysis and implications for Australia" aimed to identify groups at high risk of T2DM in Victoria. Large socio-cultural differences were found to exist where all migrant groups had higher prevalence of T2DM than the Australian-born population, suggesting that with increasing migration there are implications for health service planning and delivery and future policy.

Abouzeid M, Philpot B, Janus ED, Coates MJ, Dunbar JA. (2013). BMC Public Health, 13, 252 doi:10.1186/1471-2458-13-252.

Child sexual abuse resources

In order to support the work of the Australian Government's Royal Commission into Institutional Responses to Child Sexual Abuse, the Australian Institute of Family Studies has put together a number of resources looking at understanding, preventing and responding to child sexual abuse.  Some very useful facts and figures and summary sheets, as well as links to support organisations and reporting structures can be found here.

Indigenous Australians health and welfare publications

The Australian Institute of Health and Welfare has published performance framework reports for each State. They provide the latest information on how Aboriginal and Torres Strait Islander people are faring in each State according to a range of indicators on health status, determinants of health and health system performance.

Another report from the AIHW recently released is Expenditure on health for Aboriginal and Torres Strait Islander people 2010-11.  In that period, the Aboriginal and Torres Strait Islander population was 2.5% of the total Australian population, and health expenditure for that sector as 3.7% of the total.

Health Complaint Commissions in Australia : Time for a National Approach to Data Collection

This report shows that a national approach to the different ways Australian state and territory health entities handle complaints data would respond better to patients’ concerns and assist policy development.

Health complaint statistics are important for identifying problems and bringing about improvements to health care provided by health service providers and to the wider health care system. This paper, authored by Merrilyn Walton, Jennifer Smith-Merry, Judith Healy and Fiona McDonald, from Australian Review of Public Affairs (ARPA) overviews complaints handling by the eight Australian state and territory health complaint entities, based on an analysis of data from their annual reports.  (APO 9/11/12)

Bereavement Guidelines for Mental Health Professionals

A national charity has developed bereavement guidelines to help mental health professionals support the families and friends of mentally ill people who have suicided. SANE Australia created the guidelines after research revealed families and friends of people with mental illness who had suicided were not receiving the support they needed, despite the fact people who are bereaved by suicide are at a much greater risk of health problems and suicide themselves. SANE Australia suicide prevention project coordinator Sarah Coker said family and friends of mentally ill people who have suicided contend with an extra layer of complex emotions. Ms Coker said the guidelines were created for mental health nurses, psychologists, psychiatrists and other mental health workers to use as a consistent approach to assist bereaved families.SANE Australia offers bereavement guidelines, a mental illness and bereavement kit, and workshops to assist mental health services, available here. (ncah 21/3/13)

Staying Healthy : Preventing Infectious Diseases in Early Childhood Education and Care Services

This 5th edition of Staying Healthy — Preventing infectious diseases in early childhood education and care services by the National Health and Medical Research Council (NHMRC) represents an increased focus on a risk-management approach to infection prevention and control principles in daily care activities. Staying Healthy provides educators and other staff working in education and care services with simple and effective methods for minimising the spread of disease. It contains more ‘how to’ advice on procedures and discussing exclusion periods with parents. The advice is presented in six parts:

• concepts of infection control
• monitoring illness in children
• procedures
• issues for employers, educators and other staff
• fact sheets on diseases common to education and care services
• forms, useful contacts and websites.

Each section is colour-coded so you can quickly find the information you need.

Click here for more information on the NHMRC website, including ordering a print copy.

Supporting Consumer Participation in Health and Medical Research : Future Directions for Australia

The Consumers Health Forum of Australia (CHF) is the national peak body representing the interests of Australian healthcare consumers. CHF works to achieve safe, quality, timely healthcare for all Australians, supported by accessible health information and systems. The purpose of this paper is to explore mechanisms to support consumer participation in health and medical research. This paper also provides a snapshot of the current literature, research and policy debate surrounding these issues. Our analysis draws on extensive work in this area, including consumer consultations and literature scoping undertaken by CHF throughout 2012. (APO 27/2/13)

Caring for Carers : Evaluation of a Support Program for Carers of People with Dementia

Caring for Carers (C4C) was initiated by the Brotherhood of St Laurence in 2009 as a pilot program to assist people caring for someone with dementia in the community. It provided carers with training and follow-up support, delivered by project workers experienced in community dementia care. Over three phases it developed into a personalised program of training and ongoing support. Using action research methodology in a program logic format, the evaluation gathered evidence from stakeholders, which was fed back to enable continuous improvement in program design and delivery. At the end of the program, an overall assessment was made of its impact on carers’ experiences and wellbeing.  (APO 21/2/13)

Medical Cannabis

The purpose of this Issues Backgrounder, by the NSW Parliamentary Research Service, is to consider the key legal issues that arise in relation to medical cannabis, in particular the relationship between Commonwealth and State laws. The second part of the paper sets out some of the key background sources relevant to the inquiry, parliamentary, scientific and legal.

The paper is organised under the following headings:

• Cannabis and the law in NSW
• The relevance of Commonwealth laws
• Australian parliamentary and government sources on medical cannabis
• Medical cannabis in selected overseas jurisdictions
• Selected peer-reviewed scientific research: 2008 to 2013
• Selected peer-reviewed legal, sociological and political research: 2008 to 2013

Supporting Students Mental Health and Wellbeing

This document reflects Education Queensland's commitment to creating an inclusive learning environment that supports the mental health and wellbeing of all students. The procedure covers three areas in the support of students' social and emotional wellbeing. These are:

• mental health promotion and illness prevention - Provision of Supportive School Environment and curriculum activities that support the development of students' social and emotional skills and wellbeing.
• early intervention
• when there is reasonable suspicion that the student may have a significant social and emotional wellbeing or mental health difficulty that prevents them from engaging appropriately.

It is noted that school participation is a crucial component of care planning for students requiring clinical intervention as schools support students' mental health and social and emotional wellbeing by working in partnership with parents, clinical care providers and specialist mental health services, to ensure that they are supportive and engaging places for all students. (APO 7/7/12)

Australia's Bad Drug Deal : High Pharmaceutical Prices

Stephen Duckett et al at the Grattan Institute have prepared this report "Australia's bad drug deal : high pharmaceutical prices". Australians are paying too much for prescription drugs. The cost of this overpayment is at least $1.3 billion a year, or $3.5 million a day. This equates to 14 per cent of the entire Pharmaceutical Benefits Scheme (PBS) budget. In a time of escalating health costs and other strains on the Commonwealth Budget, spending on pharmaceuticals could be reduced relatively easily, if there is the political will to do so.

This report proposes three changes to get pharmaceutical prices under control. The first is to establish a truly independent expert board. Like New Zealand’s Pharmaceutical Management Agency, it would manage pharmaceutical pricing within a defined budget. The second and vital change is to pay far less for generic drugs, which can be bought for low prices because they are off-patent.Down the line, a third reform should encourage people to use cheaper but similar pharmaceuticals, which could save at least $550 million a year more. The pricing agreement between the Government and drug companies expires in the middle of next year. Now is the time to make changes that will end Australia’s bad drug deal. (APO 17/3/13)

The Societal Costs of Alcohol Misuse In Australia

It is well documented that alcohol-related problems compromise individual and social health, and wellbeing. The individual harms are numerous, including premature death, loss of enjoyment and loss of social utility through fear of crime and victimisation. The misuse of alcohol, particularly among those most at risk in our community, presents a major challenge for all levels of government. In this paper, The societal costs of alcohol misuse in Australia by Matthew Manning, Christine Smith and Paul Mazerolle of the Australian Institute of Criminology (AIC), a study is presented that provides a better national-level estimate of the costs of alcohol-related problems in Australia.
Despite taking a conservative estimate, the aggregate of a range of societal costs substantially outweighs the tax revenue for the Commonwealth generated from the sale of alcohol. Results of this study provide evidence to policymakers regarding costs to the criminal justice system, costs to the health system, costs resulting from lost productivity and costs related to alcohol-related road accidents. Such evidence will provide an understanding of the economic tradeoffs that are present when making decisions that affect all Australians. (APO 2/4/13)