03 September 2014

Cancer patients require better treatment for depression

Findings from three research studies have shown that around three quarters of cancer patients who suffer from major depression do not receive treatment for their depression and that a newly developed medical program has proven more effective than standard care at reducing depression in these patients.
As reported in The Lancet Psychiatry, a data analysis of more than 21,000 patients across clinics in Scotland, UK, found that the frequency of major depression among cancer patients ranged from 6% in those with genitourinary cancer to 13% among those with lung cancer. However, almost three quarters of patients with major depression were not receiving any treatment to address the problem.
The second paper published in The Lancet, reports on findings form the SMaRT Oncology-2 randomised trial which examined the effects of a new medical programme called “Depression Care for People with Cancer” (DCPC).
A further study published in The Lancet Oncology describes a version of the DCPC that was adjusted for lung cancer patients with major depression who had a poor rather than good cancer prognosis.
CIAP users can access the full text of The Lancet and Lancet Oncology. Contact your library for access to Lancet Psychiatry.

Wnt Signalling Pathways

The Wnt signaling pathways are a group of signal transduction pathways made of proteins that pass signals from outside of a cell through cell surface receptors to the inside of the cell. A special issue of Developmental Neurobiology titled "Wnt Signaling Mechanisms in Development and Disease" is open access.
It includes five review articles and two original papers that capture these new exciting aspects of Wnts and the Wnt signaling pathways in the nervous system development and disease. Changes of Wnt signaling components have been observed in Alzheimer's disease and Parkinson's disease. Further understanding of the targets regulated by Wnts will inspire strategies for the treatment and perhaps cure of developmental and neurodegenerative conditions where Wnts play a central role.

29 August 2014

Transition care for older people leaving hospital

Today the Australian Institute for Health and Welfare has published Transition care for older people leaving hospital: 2005-06 to 2012-13

This report looks at the Transition Care Program which assisted more than 87,000 people between 2005 and 2013.  81% of the recipients completed their planned care under the program, and of them 76% had improved functional status.  54% of care recipients returned to live in the community, and of these two thirds did not enter residential aged care within 12 months.

AIHW 2014. Transition care for older people leaving hospital: 2005-06 to 2012-13. Aged care statistics series 40. Cat. no. AGE 75. Canberra: AIHW

Updates to mental health services website

The Australian Institute of Health and Welfare's Mental Health Services in Australia website has undergone some significant updates:

  • Medicare-subsidised mental health-related services (MBS) 2012-13
  • Mental health-related prescriptions (PBS) 2012-13
  • updates to the Australian Government expenditure on Medicare-subsidised mental health-related services and subsidised prescriptions 2012-13
  • updates to the MBS & PBS data in the state and territory summary tables 

Rapid response systems in hospitals

The incidence of inhospital cardiac arrests (IHCAs) has decreased by more than 50% in those Australian hospitals with rapid response systems (RRSs), according to an article recently published in the Medical Journal of Australia.  Cardiopulmonary arrest and mortality trends, and their association with rapid response system expansion by Jack Chen et al, explains that as RRSs have been progressively introduced since 2002 there has been a coincidental reduction in hospital mortality due to IHCAs and and increased survival to hospital discharge.

One of the paper's authors, Kenneth Hillman, wrote a piece summarising the research in a recent issue of The Conversation: Rapid response teams halve hospital heart attack deaths.

Med J Aust 2014; 201 (3): 167-170. doi: 10.5694/mja14.00019.  Access the full text via CIAP or ask your health librarian. 

Medicinal use of cannabis

The Australian National Council on Drugs (ANCA) has published Medicinal use of cannabis: background and Information paper, which provides an overview of what is known about medicinal cannabis use in Australia and internationally, the current state of the scientific and medical evidence for its use, and issues with the current situation in Australia.

It seems that there is a lack of evidence on this topic, largely due to the fact that it it still illegal in Australia.  "...there is a need to disentangle medical and scientific questions from legal and ideological ones in considering whether and how medicinal cannabis should be used in Australia. This is difficult to achieve, since the range of acts and regulations that control non- medicinal uses of cannabis will necessarily impact on medicinal use."

For more recent information about this topic, see a recent Sydney Morning Herald report by Melissa Healy about a JAMA study, Medical marijuana could reduce painkiller abuse. Also, see the NSW Cancer Council's Medical Use of Cannabis (marijuana) Position Statement

27 August 2014

National Alcohol and Drug Knowledgebase

The National Alcohol and Drug Knowledgebase (NADK) has been developed by the National Centre for Education and Training on Addiction at Flinders University, with support from the Australian Government Department of Health.  The website "... draws on the highest quality Australian data to provide accurate and easy-to-understand information about alcohol and other drugs."

Information is presented by way of FAQs, with sections on alcohol, cannabis, pharmaceuticals and methamphetamines.  Much of the site is still under construction, but it looks like it will prove to be a valuable resource for quick access to synthesised data in these areas.

Paediatric palliative care website

The NSW Paediatric Palliative Care Program has developed this new website aiming to provide families and health professionals with information about children with life-limiting illness. The parents and carers section includes information about bereavement, keeping memories and support networks.  The health professionals section includes referral information, models of care, symptom management and education.

The program has been developed jointly by the Children's Hospital at Westmead, Sydney Children's Hospital and John Hunter Children's Hospital, along with the NSW Agency for Clinical Innovation (ACI).

21 August 2014

Oral health and dental care in Australia

A recent report from the Australian Institute of Health and Welfare highlights the trends in oral health historically.  Oral health and dental care in Australia: key facts and figures, suggests that although there have been some improvements over the long term, there have been some concerns in recent years. For example, although there was a drop in the average number of decayed children's baby teeth from 1977 to 1995, since then there has been a gradual rise.

Dental visiting patterns have generally increased with the proportion of people over 15 who made a dental visit in the previous 12 months increasing from 56% in 1994 to 62% in 2010.  The cost of visiting the dentist remains a concern for some people, and there has been a growth in the supply of dental practitioners in recent years.

Contradictory studies on salt consumption effects

Bruce Neal, from the St George Institute of Global Health, has recently written "Best to ignore salt claims..." in The Conversation about conflicting studies which have just been published in the New England Journal of Medicine.  One of the studies was from the Global Burden of Disease program, finding that too much salt was causing millions of premature deaths and was especially related to high blood pressure.  The other study was a Prospective Urban and Rural Epidemiological (PURE) study, involving a large data set from around the world.  This cohort study found that high salt intake was unlikely to be related to blood pressure and suggested that World Health Organisation salt intake guidelines were set too low.

Neal argues that the PURE study was flawed in its findings, and that "Randomised trials of salt reduction show clear benefits on blood pressure, the leading cause of premature death in the world. This is the best evidence we have to date and it’s the evidence that should drive health policy".

Find the reports of the studies, as well as an editorial, in the New England Journal of Medicine, August 14 edition, volume 371, no. 7.  Full text can be obtained through CIAP or by asking your health librarian.

Youth Mental Health report 2014

Mission Australia in conjunction with the Black Dog Institute has reported that one in five young Australians are experiencing mental illness, with less than 40% of them feeling comfortable in seeking professional help.

The Youth Mental Health Report 2014 surveyed almost 15,000 15-19 year olds across Australia and found that females and Aboriginal respondents were far more likely to be experiencing mental illness.  These people showed a high concern about depression, suicide, bullying and family conflict. The report recommends various measures such as awareness programs in schools, peer education, reducing the stigma of mental illness and a focus on prevention and early intervention.

19 August 2014

Mortality from asthma and COPD in Australia

Asthma death rates in Australia are high compared with many other countries and chronic obstructive pulmonary disease (COPD) is a leading cause of deaths in Australia and internationally. This report by the Australian Institute of Health and Welfare provides current information about mortality due to these conditions in Australia, examining trends over time, seasonal variation, international comparison and variation by age, sex, remoteness, Indigenous status, country of birth and socioeconomic disadvantage.

Click here to view the full report.                     

Prostate Cancer Breakthrough

The Trans-Tasman Radiation Oncology Group has conducted a five year trial, with the results published in the Lancet Oncology journal. The trial involved the Hunter Medical Research Institute, the University of Newcastle and the Calvary Mater. More than 1,000 men were involved, with doctors using testosterone suppression therapy, radiotherapy as well as a different type of anti-cancer drug. The combination therapy reduced the spread of aggressive, localised tumours by more than 40 per cent.

Denham et al., (2014). Short-term androgen suppression and radiotherapy versus intermediate-term androgen suppression and radiotherapy, with or without zoledronic acid, in men with locally advanced prostate cancer (TROG 03.04 RADAR): an open-label, randomised, phase 3 factorial trial. The Lancet Oncology, Early Online Publication, 15 August 2014. doi:10.1016/S1470-2045(14)70328-6

You will need to contact your library to access the complete article.

Guidelines for the management of overweight and obesity in adults

This special issue of the journal Obesity, has provided the Guidelines (2013) for Managing Overweight and Obesity in Adults as open access. The Executive Summary of the Guideline is copublished in three journals: Obesity, Circulation, and the Journal of the American College of Cardiology.

(2014). Executive summary: Guidelines (2013) for the management of overweight and obesity in adults. Obesity,  22(S2), S5-39

Ebola Haemorrhagic Fever

The Centers for Disease Control and Prevention (CDC) is regularly updating it's pages on Ebola, with information on transmission, signs and symptoms, and guidelines for air transport and gowning up. This government run organisation in Washington would be one of the best sources of reliable information.