New osteoporosis recommendations

Building healthy bones throughout life. An evidence-informed strategy to prevent osteoporosis in Australia has been published by MJA Open and authored by Osteoporosis Australia.
1.2 million Australians have osteoporosis and a further 6.3 million have osteopenia.  Fragility fractures cost our economy billions of dollars per year.  The main recommendations from this document are that:

• Daily dietary calcium intakes should be consistent with Australian & NZ guidelines
• Serum levels of vitamin D in the general population should be above 50 nmol/L in winter or early spring
• Regular weight-bearing physical activity, muscle strengthening exercises and balance activities should be undertaken. 

MJA Open 2 Suppl 1 · 4 February 2013 1

Elective hip and knee-replacement surgery in Australian public hospitals

The journal, Australian Health Review has recently published an open access article on the waiting lists for elective surgery and the problems caused for our health systems.
"The progression through elective surgery waiting lists can be likened to a game of snakes and ladders where barriers (snakes) delay access to surgery and facilitators (ladders) expedite access. The aim of the present study was to describe the barriers and facilitators to delivery of total hip- and total knee-replacement surgery in South Australian public-funded hospitals." (from article abstract)
Snakes and ladders: the barriers and facilitators of elective hip- and knee-replacement surgery in Australian public hospitals by Julie L. Walters A, Shylie F. Mackintosh A and Lorraine Sheppard. 2013.
Australian Health Review 37(2) 166-171

"Influenza vaccines: time for a rethink"

In this recent JAMA article, author Peter Doshi challenges the basic assumption that influenza is "a major public health threat for which the annual vaccine offers a safe and effective solution."  Doshi argues that there is no evidence that vaccines reduce the serious complications of influenza.  He says that the media and health promotional messages confuse the influenza virus with "flu", causing people to have unrealistic expectations about the vaccine's potential benefit.  Doshi also highlights the risks and benefits of influenza vaccines and calls for more discussion on the topic. 

JAMA Intern Med. 2013;():1-3. doi:10.1001/jamainternmed.2013.490. 

painHEALTH - new website for chronic pain

painHEALTH is a new website from WA Health, aimed at helping the estimated 700,000 Australians suffering from musculoskeletal pain such as low back pain, neck pain, osteoarthritis, osteoporosis and rheumatoid arthritis.  The aim is to provide these sufferers with evidence based information on how best to manage their conditions.  The site includes pain stories from people with chronic musculoskeltal pain, pain management training modules, links to various resources, pain self-checks and basic information about pain.

Euthanasia background paper

Euthanasia is an updated background paper by Gareth Griffith and Lenny Roth of the NSW Parliamentary Library.  In light of the recent introduction of the Rights of the Terminally Ill Bill in NSW, this paper examines recent cases in Australia, proposed reforms and recommendations in selected jurisdictions, especially South Australia, Tasmania and the United Kingdom.  Sections on Canada and New Zealand are also included, with reference to recent journal articles and media reports.

Antibiotics and chronic back pain

A Danish study in the European Spine Journal received some publicity last week when it showed that 40% of chronic back pain could be helped with antibiotics rather than surgery.

This study supported previous studies which have demonstrated that many patients undergoing surgery for a first-time disc herniation have a bacterial infection.  An item on ABC's PM program sought the reaction of Peter Wilde, President of the Spine Society of Australia.

Ask your librarian for the full text of the article, Eur Spine J (2013) 22:697–707 DOI 10.1007/s00586-013-2675-y.  "Antibiotic treatment in patients with chronic low back pain and vertebral bone edema (Modic type 1 changes): a double-blind randomized clinical controlled trial of efficacy" by Hanne B. Albert et al.

Mothers and babies bedsharing

This week's Health Report on ABC Radio National, included an interview with Catherine Fetherston from Murdoch University, whose article in Breastfeeding Review late last year provoked some controversy.  In the interview (read the transcript or listen here), Fetherston questioned the current recommendations which caution against babies sleeping with their mothers as a risk for SIDS.  She states that this is not evidence-based as other risk factors have not been accounted for, such as smoking, alcohol consumption, sleeping in a chair or on a sofa.

Analysis of the ethical issues in the breastfeeding and bedsharing debate, Fetherston, C. & Leach J.
Breastfeed Rev. 2012 Nov;20(3):7-17.

Heart disease and risk of depression

Around 40 per cent of people experience mild forms of depression after a heart attack or bypass operation and 15 per cent experience major depressive disorder. Aside from the obvious problems, depression hinders recovery from the heart operations. The Heart Foundation has highlighted this, in their statement, Heart Disease Patients face higher depression risk.  They recommend routine screening for depression in all people diagnosed with heart disease.

The Heart Foundation refers to a recent article in the Medical Journal of Australia, Screening,referral and treatment for depression in patients with coronary heart disease by David M. Colquhoun et al.  The authors update the evidence on all levels of depression in patients with coronary heart disease, and provide guidance for health professionals on the screening and treatment of this condition.  
– Med J Aust 2013; 198 (9): 1-7.

Why fund the National Disability Insurance Scheme?

Why fund NDIS? : because some day you might need it is an opinion piece by Stella Young, published on the ABC's disability discussion site, Ramp-Up.  As someone who is disabled, Stella mounts a convincing argument for everyone to contribute to the scheme.  "For people with disabilities, myself included, discussions about the money are simply beside the point. We don't think about the NDIS in terms of dollars; we think about it in terms of showers per week, mobility aids that meet our needs and general access to our communities."

Younger onset dementia report

Younger onset dementia : a new horizon? was launched this week by Alzheimer's Australia.  It documents the unique challenges faced by the 24000 people living with younger onset dementia in Australia, and suggests how the National Disability Insurance Scheme and other funding systems should respond to their needs. The report was launched by Ita Buttrose, who spoke about these sufferers, who "don't typically qualify for aged care and find it difficult to fit into disability services because they have to cope with a completely different set of professional and family-related issues.  They also experience difficulties accessing respite care, getting a diagnosis and dealing with stigma and isolation within the broader community."

Q & A - The Health Debate

ABC TV aired a special episode of Q & A in April as a lead-up to the federal election. Host Tony Jones was joined by Minister for Health Tanya Plibersek and Shadow Minister for Health, Peter Dutton.  Topics discussed included:

• Hospital funding
• Health cost blow-out
• Palliative care
• Organ donation
• Medicare locals
• Health professional training
• Rural and remote health
• e-health
• Dementia prevention
• Indigenous health gap

The Health Debate is available for viewing, or download the transcript. 

Social media and health - new articles

The use of social media by health professionals and consumers is no longer new, but it is a constantly developing phenomenon and there have recently been a few interesting studies published: 

Social media in primary health care: Opportunities to enhance education, communication and collaboration among professionals in rural and remote locations: Did you know? Practical practice pointers by Anikeeva and Bywood in the Australian Journal of Rural Health, looks at blogs, microblogs and wikis.  The authors give some useful practical advice and encourage involvement in implementation and design. AJRH, 21(2), 132-134.

Social networking in online support groups for health:How online social networking benefits patients by Chung in the Journal of Health Communication: International Perspectives, discusses online social media such as patient blogs and Internet support groups as sources of health information. The author conducted an online survey with current users of online support groups and how different people use them to receive emotional and informational support. 

DOI:10.1080/10810730.2012.757396.

 

A new dimension of health care: Systematic review of the uses, benefits, and limitations of social media for health communication by Moorhead et al has been published in The Journal of Medical Internet Research. According to the authors there is a lack of information about the uses, benefits, and limitations of social media for health communication among the general public, patients, and health professionals, and this requires investigation. Using a systematic search of the literature they identified seven main uses of social media for health communication, as well as a number of limitations and gaps. They concluded that social media is a powerful tool that does bring a new dimension to health care, offering a communication medium for the public, patients, and health professionals to discuss health issues with the possibility of potentially improving health outcomes. JMIR 15 (4), e85. 

Please contact your health library if you have trouble accessing the fulltext of these articles.

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.