26 November 2015

Violence against immigrant and refugee women

With White Ribbon Day receiving good media coverage this week, one timely paper recently published is from Australia's National Research Organisation for Women's Safety (ANROWS) - Promoting community-led responses to violence against immigrant and refugee women in metropolitan and regional Australia. 

This paper presents the state of national and international knowledge about family violence against immigrant and refugee women. Some of the findings include the fact that although there are similar forms of family violence for these women as other women, there are differences where women depend on perpetrators for economic security and residency rights.  There is very little evidence that mandatory arrest and pro-prosecution approaches are helpful for these women, and they may even deter them from seeking help. 

OECD review of health care quality in Australia

The OECD has also published a series of reviews of health care quality in member countries, and OECD Reviews of Health Care Quality: Australia 2015: Raising Standards  notes that the Australian system is a generally high and performs at moderate cost, despite being very complex. 

The report describes many of the quality activities being undertaken and suggests how the system could be improved, such as an enhanced federal government role in steering policy, funding and priority setting. 

Health at a glance 2015 - OECD indicators

This year's summary report on health and health care in the OECD nations, Health at a Glance 2015: OECD indicators, reports that while life expectancy continues to rise, there are still widespread differences across countries and socioeconomic groups.

The report presents the most recent comparable data on the performance of health systems in each country and also in some instances data for partner countries (Brazil, China, Colombia, Costa Rica, India, Indonesia, Latvia, Lithuania, Russian Federation and South Africa). This edition also includes a new set of dashboards of health indicators looking at the relative strengths and weaknesses of OECD countries on different key indicators of health and health system performance.  There is a special focus on the pharmaceutical sector and on health workforce migration.

Coffee consumption and mortality

A major study published in the journal Circulation has recently concluded that "Higher consumption of total coffee, caffeinated coffee, and decaffeinated coffee was associated with lower risk of total mortality."

The study, conducted by the Harvard School of Public Health was based on data gathered from three large, ongoing surveys including around 300,000 nurses and other health professionals over a 30 year period. The results indicated that people who drank three to five cups of coffee a day (either caffeinated or decaffeinated) have a reduced risk of death from heart disease, diabetes, suicide and neurological diseases.

Ding, Ming et al. Association of coffee consumption with total and cause-specific mortality in three large prospective cohorts. Cirulation AHA.115.017341 Published online before print November 16, 2015, doi: 10.1161/CIRCULATIONAHA

25 November 2015

Why go gluten-free?

This week the ABC program, Catalyst, aired Gluten: a gut feeling, looking at why so many people who have not been diagnosed with coeliac disease are opting for a gluten-free diet. Many people say that giving up gluten in their diet has helped with gastrointestinal issues, but Professor Peter Gibson from Monash University says it could be something other than gluten that has been causing the problem. Fructans are also present in wheat and are part of a group of carbohydrates called FODMAPs. Giving up foods rich in FODMAPs would be a lot less restrictive than going gluten-free.

More information on this was published in an article recently in The Conversation: Why do people decide to go gluten- or wheat-free? by Sinead Golley from the CSIRO. She points out that "according to current Australian Dietary Guidelines, grain- and dairy-based foods are important components of a balanced diet".

Mentioned in this article was a study Golley co-authored, published earlier this year in the journal Public Health Nutrition, Motivations for avoiding wheat consumption in Australia: results from a population study.  Over 1000 randomly-selected adult Australians were surveyed and a significant number were avoiding the consumption of wheat, mainly without any medical diagnosis.

2015 Feb;18(3):490-9. doi: 10.1017/S1368980014000652..

Brain-eating amoeba - Naegleria fowleri

Wellcome Images
A recent episode of Australian Story on the ABC told about the tragic death of a very young boy in Northern Queensland due to the amoeba Naegleria fowleri in water from a garden hose.

More information on this amoeba and the  primary amoebic meningoencephalitis it causes can be found in the explanatory piece, "What are brain-eating amoeba and how can we reduce their harm?" published by gastroenterologist and academic, Vincent Ho, in The Conversation. Fortunately, infections of this type from Naegleria fowleri are quite rare, as opposed to another amoebic organism, Entamoeba histolytica which is estimated to result in up to 100,000 deaths per year across the world.

Are we ready for the next flu?

Lisa Jackson Pulver from the Centre for Defence and Strategic Studies at the Australian Defence College has written this briefing paper: Questions from the lab – is Australia and the near region ready for the next attack of ‘flu?

Pulver contends that the seemingly ‘common flu’ is an example of a non-traditional threat for which Australia and its near neighbours are particularly underprepared. She notes that new pathogens are always emerging and changing to resist human efforts to control them, and provides an overview of the history and current status of the influenza virus.

Sleep deprivation and starvation in hospitalised patients

The authors of this open-access opinion piece in the journal BMJ Quality and Safety highlight the neglect of quiet and nutrition in some hospitals and how, rather than helping to treat patients, they are actually harming them. "As we seek to improve quality through patient-centredness, basic human needs are important in the context of complex medical care. We should view hospitals as healing environments rather than isolated clinical spaces and design patient care accordingly.”

Xu T, Wick EC, Makary MA Sleep deprivation and starvation in hospitalised patients: how medical care can harm patients.  BMJ Qual Saf doi:10.1136/bmjqs-2015-004395

Deaths in Australia in 2013

The Australian Institute of Health and Welfare has updated its web pages to include the analysis of all 147,678 deaths registered in Australia in 2013.  Despite the slight decline in cancer mortality rates, the number of deaths due to all neoplasms was greater than the number of deaths due to circulatory diseases for the first time in 2013 (44,674 deaths and 43,603 deaths respectively).  A third of deaths were in people under 75 years of age, and the difference in death rate between males and females has lessened over time.  51% of deaths occurred among people admitted to hospital.

Find out more details about death statistics, trends, life expectancy, causes of death and more on the AIHW Deaths web pages.

18 November 2015

Menopause: diagnosis and management

The UK’s National Institute for Health and Care Excellence (NICE) has published a new guideline on menopause.  The guideline aims to improve the consistency of support and information provided to women in menopause and is intended both for healthcare professionals who care for women in menopause and women in menopause, and their families and carers.

NICE Guideline NG23:  Menopause: diagnosis and management  November, 2015.

Stroke Riskometer app

This app has been produced with the claims that it “is a unique and easy to use tool for assessing your individual risk of a stroke in the next five or ten years and what you can do to reduce the risk. The app can also give you an indication of your risk of heart attack, dementia, and diabetes.”

In 2014, out of 100,000+ health-related apps, Stroke Riskometer™ App has been selected by leading doctors as a top health app worldwide (number 1 app in Medical Conditions category for iOS). The app won based on its medical accuracy, its utility in supporting health or healthy living goals, and usability. Stroke Riskometer™ was a finalist for New Zealand Innovators Award, category Innovation in Health & Science.

Continuous improvement of patient safety

The UK charity the Health Foundation has published a new report on the lessons learned from their work on improving patient safety in the NHS. According to the Health Foundation’s website:

"Part I of the report illustrates why improving safety is so difficult and complex, and why current approaches need to change.

Part II looks at some of the work being done to improve safety and offers examples and insights to support practical improvements in patient safety.

In Part III, the report explains why the system needs to think differently about safety, giving policymakers an insight into how their actions can create an environment where continuous safety improvement will flourish, as well as how they can help to tackle system-wide problems that hinder local improvement."

Continuous improvement of patient safety: The case for change in the NHS. Learning report. Illingworth J., London: The Health Foundation; 2015.

Patient Experiences in Australia: Summary of Findings, 2014-15

The Australian Bureau of Statistics Patient Experience Survey is conducted annually and collects data on access and barriers to a range of health care services, including:
  • general practitioners (GPs)
  • medical specialists
  • dental professionals
  • imaging and pathology tests
  • hospital admissions
  • emergency department visits (ED)
It includes data from people that accessed health services in the previous 12 months, as well as from those who did not, and enables analysis of health service information in relation to particular population groups. Data are also collected on aspects of communication between patients and health professionals.

4839.0 - Patient Experiences in Australia: Summary of Findings, 2014-15 

Treatment of acute stroke: an update

About 17 million strokes occur worldwide each year and it is the second leading cause of global mortality and a major cause of neurological disability. Patients with stroke often require long-term rehabilitation following the acute phase, with ongoing support from the community and nursing home care. In this overview published in the Journal of Internal Medicine, the current strategies for specific treatment of stroke in the acute phase, focusing on intravenous thrombolysis and mechanical thrombectomy are discussed. Two important issues related to intravenous thrombolysis treatments: (i) how to shorten the delay between stroke onset and treatment and (ii) how to reduce the risk of symptomatic intracerebral haemorrhage are also considered.

This article is free online until Dec 15, 2015, after this date please contact your library.

Mikulik, R., & Wahlgren, N. (2015). Treatment of Acute Stroke: an update. Journal of Internal Medicine, 278(2), 145-165

11 November 2015

Preventing suicide by young people

Preventing suicide by young people is a discussion paper from BoysTown, the organisation that runs the Kids Helpline. The paper reports that "In 2013, 2,522 people died by suicide in Australia. Twenty-two of these were children aged 5- 14 years, 148 were adolescents aged 15-19 years, and a further 200 were young people aged 20-24 years."  Suicide is in fact the leading cause of death in children and young people.

The paper outlines risk and protective factors against suicide for young people, looks at what's happening in preventive and early intervention in Australia, examines clinical and service interventions and discusses opportunities for improvements across the board.  There is a useful guide and summary to Apps aimed at suicide intervention as an appendix.