13 November 2014

Health promotion in Aboriginal and Torres Strait Islander communities

A special edition of the Australian Journal of Primary Health focuses on Health Promotion in Aboriginal and Torres Strait Islander Communities.  Authors Kerry Arabena, Kevin Rowley and Sarah MacLean look at these communities and the importance of family and the natural world.   They discuss building capacity within their organisations and changing the way mainstream communities interact with Aboriginal and Torres Strait Islander peoples. A clear message is that for too long Aboriginal and Torres Strait Islander people have been described as having problems that are too big and complex to be solved within communities themselves bu now we are changing the collective story from one of deficit, to one of strength and resilience.

Contact your health library if you have trouble accessing the full text.

Australian Journal of Primary Health Special Issue, Volume 20, Number 4.

Medicine list smartphone app

NPS MedicineWise have developed a free app for an iPhone or Android smartphone, where patients can store a list of their medications.

MedicineList+ allows people to keep all the information about their medicines in one place, and includes alarms and reminders about when to take medicine. It's a handy tool to help prevent medication error, and easily reviewed by health professionals generally, and in an emergency.

NICE evidence updates

The National Institute for Health and Care Excellence (NICE) in the UK, regularly publish Evidence Updates on their website, which summarise new evidence on various clinical subjects, highlighting key points and commenting on the strengths and weaknesses of the new and old evidence.

The latest update is on Headaches which updates their guideline CG150 ‘Headaches: Diagnosis and management of headaches in young people and adults’ with selected new evidence.  New topics coming soon include lower limb peripheral arterial disease and psoriasis - both due in mid November. Topics are searchable by specialty or by date, and you can subscribe on the site for email updates.

Taking a best possible medication history

Get it right! Taking a best possible medication history is an online learning module aimed at junior medical officers, nursing and pharmacy staff for admitting patients to hospital.  Obtaining an accurate medication history (known as a best possible medication history or BPMH, is the first step in the medication reconciliation process and helps with making therapeutic decisions.

The module includes a video which explains what information should be recorded and how certain techniques can influence the accuracy of the history obtained.  There is al a short role-play scenario and some useful tips. Nurses and pharmacists can earn professional development points by completing the module, which was developed by the Australian Commission on Safety and Quality in Health Care and NPS MedicineWise. You will need to complete a free registration process before you get started.

12 November 2014

Arthritis and disability

Arthritis and Disability is a report on the lived experience of people with arthritis and similar conditions.  It was commissioned by Arthritis Australia and outlines the methods, findings and implications of this research, carried out by the Social Policy Research Centre at the University of New South Wales.

Arthritis is the second leading cause of disability and the most common cause of chronic pain in Australia, and the most prevalent long-term health condition, affecting 3 million people or about 15 per cent of the population. This work looks at the extent to which arthritis is associated with disability–who is affected, how people are affected, what helps people cope with their condition day to day, and how support services can be improved.

Australia's falling birth rate

The Australian Bureau of Statistics has released new birth rate figures, showing that this country's birth rate is the lowest since 2006.  Births, Australia, 2013 indicates that Australia's total fertility rate fell from 1.93 in 2012 to 1.88 in 2013.  Conversely, the trend among older mothers, between 40 and 44 years, has shown increased fertility since the mid 1970's, almost tripling in the last 30 years.

Cardiovascular disease, diabetes and chronic kidney disease mortality

This AIHW report describes deaths in the Australian population as a result of three chronic conditions, singly or in combination. Cardiovascular disease, diabetes and chronic kidney disease: Australian facts: mortality reports that in 2011, these three diseases together were the underlying cause of almost 53,000 deaths - 36% of all deaths.  Overall 61% of all deaths had at least one of these diseases recorded as an underlying or associated cause of death. CVD was the underlying cause of 45,622 deaths, 31% of all deaths. CHD accounted for 47% of CVD deaths, followed by stroke (19%). CVD contributed to 56% of all deaths.

The CVD mortality rate has declined significantly since 1981, while the diabetes rate has remained unchanged, and CKD mortality has been stable since 2000. In 2011, the rates of all these diseases were higher in males, older people and people in lower socioeconomic groups.

Healthy eating guidelines for metabolic and endocrine diseases

The American Association of Clinical Endocrinologists has released a new guideline, Clinical practice guidelines for healthy eating for the prevention and treatment of metabolic and endocrine diseases in adults.  The Guideline, cosponsored with the American College of Endocrinology and the Obesity Society, targets adults with or at risk of metabolic and endocrine diseases and considers morbidity, mortality, obesity, pregnancy issues, elderly care and malnourishment in making very specific dietary recommendations.

Palliative care factsheets for patients and carers

CareSearch Palliative Care Knowledge Network has just released a new feature on their website called My Information Kit.  This site allows health professionals to select relevant factsheets which have been compiled by CareSearch, the Australian Centre for Grief and Bereavement, Palliative Care Australia and Carers NSW, for printing or emailing to patients and carers. There is provision for a cover sheet to be attached including your name and contact details.

The factsheets cover a range of issues including bereavement, support and wellbeing for carers, pain, communication and living with a terminal illness.

Australian hospital statistics 2013–14: emergency department care

This report from the Australian Institute of Health and Welfare reveals that there were over 19,700 presentations per day in public hospital emergency departments in 2013-14 - an increase of 7.2% from the previous year.  75% of patients were "seen on time", with NSW hospitals performing best at 81%.  Nationally, the proportion of emergency department visits complete in 4 hours or less increased from 64% to 73% since the last report.  In NSW that figure increased from 60% to 74% over the past two years.  29% of emergency department patients were admitted to hospital after their ED care.

For these and many other interesting statistics, broken down to State level, access the full report. AIHW 2014. Australian hospital statistics 2013–14: emergency department care. Health services series no. 58. Cat. no. HSE 153. Canberra: AIHW.

Sense of smell and mortality

Being unable to smell in older adults could be a predictor of increased risk of death within five years. In a study of more than 3,000 people aged 57 to 85, 39 per cent of subjects who failed a simple smelling test died within five years, according to results published in the journal PLOS One.
"Compared to a person with a normal sense of smell, a person with an absent sense of smell has three times greater risk of dying within a five-year span," says the study's lead author Dr Jayant Pinto of the University of Chicago. If one's sense of smell is in decline, it could be a warning for your GP to look further.

Pinto, Jayant M. [et al] (2014). Olfactory Dysfunction Predicts 5-Year Mortality in Older Adults. Plos One. DOI: 10.1371/journal.pone.0107541

05 November 2014

Guideline for the treatment of juvenile idiopathic arthritis

There has been an update of the 2011 American College of Rheumatology recommendations for the treatment of juvenile idiopathic arthritis: recommendations for the medical therapy of children with systemic juvenile idiopathic arthritis and tuberculosis screening among children receiving biologic medications. The guideline summary is available on the National Guideline Clearinghouse site.

 Update of the 2011 American College of Rheumatology Recommendations for the Treatment of Juvenile Idiopathic Arthritis. (2013), Arthritis and Rheumatism. Vol. 65, No. 10, October 2013, pp 2499–2512 DOI 10.1002/art.38092

30 October 2014

PTSD and Stigma in the Australian Army

This paper by John Bale and published by the Australian Army seeks to identify the nature of the stigma attached to Post-traumatic Stress Disorder (PTSD) and other mental health conditions in the Australian Army.  It also looks at the negative implications of such a stigma on the individual, the workplace and the Army as a whole.

PTSD needs to be identified and treated early but many people fear the negative judgements of people around them so do not receive early diagnosis.  Previous reports have found that stigma surrounding mental health issues is a considerable barrier in the Australian Defence Force and particularly in the Army.  PTSD and Stigma in the Australian Army analyses Canadian, British and US initiatives and provides key recommendations to the Australian Army on how to combat stigma.

Impacts of climate change on public health in Australia

This Deeble Institute Issues Brief looks at the immediate and longer-term impacts of climate change and how it may affect Australian health and social environments.  The authors call on Federal and State Governments and agencies within the Australian public health sector to heed the information, opinions and recommendations provided here and offer them guidelines for decision-making in responding to climate change impacts.

"A new approach, based on ecological principles, will be required to navigate through the complex and interrelating health causes. The public health sector must strengthen existing approaches for effective climate change adaptation strategies, including assessing regional health risks to identify vulnerable and resilient populations, collecting enhanced surveillance data and developing monitoring indicators."

Impacts of climate change on public health in Australia: Recommendations for new policies and practices for adaptation within the public health sector.  Walter T, Stevens P, Verhoeven A & Boxall A. Deeble Institute for Health Policy Research (2014). 

Call for more generalist doctors and specialist nurses

In an article recently published in The Conversation, Professor Don Campbell from Monash University explains Why hospitals need more generalist doctors and specialist nurses.  With an ageing population with complex needs making increasing demands on our hospitals, Campbell argues that "we need to redesign the workforce so hospitals are staffed by general physicians and nurses who take on more complex roles."

Because we are living longer we are likely to develop multiple chronic diseases so need a generalist to manage our care. Nurses however need to up-skill into more specialist roles.  Examples of hospital workforce reform along these lines is given from the UK, the US and New Zealand.