Australian Government Directory of Services for Older People 2010

Minister for Ageing, Justine Elliot has launched the Directory of Services for Older People 2010. The free directory provides important information for older people and their families with chapters on accessing aged care, legal rights, finance and health. Available in PDF, large-print PDF and print versions.

Press release

National grants to get city doctors working in the bush

Minister for Health and Ageing Nicola Roxon and Minister for Rural and Regional Health, Warren Snowdon have launched a national program that will offer emergency training for up to 150 urban GPs in exchange for their undertaking a locum placement in a rural or regional areas.

The Rudd Government is providing $790,000 over four years for the Rural Education Assistance Program (Rural LEAP), which aims to give rural and remote doctors a break by providing increased locum services.

Speaking on a tour of Mt Isa and Cloncurry in north-west Queensland, Mr Snowdon said Rural LEAP will help give urban GPs the skills and confidence to undertake a rural locum placement.

Press release and fact sheet.

The New Superfruits

Take a break from your usual apple-orange-banana routine. Treat your tastebuds and your health to these exotic, antioxidant-rich summer-ripe alternatives.
By Monica Bhide and Jennifer Pinkerton
Although Australians are eating more fruit these days (way to go!), most of us steer towards the old standbys: bananas, apples and oranges. Yes, they're good for you—but you're missing out. Other fruits are packed with a host of antioxidants, vitamins, and minerals that fight disease, keep your digestive system healthy, and help control your cholesterol levels, says Dr Joanna McMillan Price, co-author of Star Foods ($35; ABC Books). In fact, broadening your fruity horizons can measurably improve your health. Nutritionists from Colorado State University in the US asked 106 women to eat eight to 10 daily servings of produce for eight weeks. Half the group chose from 18 varieties, and the others ate the same five over and over. Two weeks later, blood tests showed that the high-variety group had reduced rates of DNA oxidation, possibly making their bodies more resilient towards disease; the other group showed no change. Ready to add some new superstars to your repertoire? We highlight some of the smartest 'exotic' picks based on their health benefits—plus easy recipes for serving them in lieu of your usual staples.

Surplus of serotonin receptors may explain failure of antidepressants in some patients

An excess of one type of serotonin receptor in the centre of the brain may explain why antidepressants fail to relieve symptoms of depression for 50 percent of patients, a new study from researchers at Columbia University Medical Center shows.The study, in a mouse model, is the first to find a causal link between receptor number and antidepressant treatment and may lead to more personalised treatment for depression, including treatments for patients who do not respond to antidepressants and ways to identify these patients before they undergo costly, and ultimately, futile therapies.

Emergency Surgery Guidelines (NSW Health)

These Guidelines have been developed by experienced surgical staff routinely coping with the challenges of emergency surgery. The Guidelines define the principles underpinning the redesign of emergency surgery and are to be referenced by Area Health Services when initiating redesign of emergency surgery practices.

Freely available on-line drug and alcohol powerpoint lectures for GPs, students, nurses, and other healthcare workers

The University of Sydney's Discipline of Addiction Medicine is providing thirteen freely available online drug and alcohol powerpoint lectures covering ten subjects. These lectures are an educational resource designed for GPs, students, nurses, AOD healthcare workers and those interested in drug and alcohol education. Subjects include prescription medicine misuse, smoking, alcohol, opioids, cannabis and stimulants.

Cardiology Top Stories of 2009 by Journal Watch

Please contact your library for copies of Cardiology top ten articles. These 10 articles are also available through CIAP

1.Cardiac-Resynchronization Therapy for the Prevention of Heart-Failure Events
Moss AJ, Hall WJ, Cannom DS, Klein H, Brown MW, Daubert JP, Estes NAM 3rd, Foster E, Greenberg H, Higgins SL, Pfeffer MA, Solomon SD, Wilber D, Zareba W.
N Engl J Med 361:1329, October 1, 2009
Patients with cardiac disease and reduced left ventricular function are at increased risk for arrhythmia-related sudden death and heart failure. The placement of an implantable cardioverter-defibrillator (ICD) improves survival and reduces the risk of sudden death in appropriately selected patients…

2. Fractional Flow Reserve versus Angiography for Guiding Percutaneous Coronary Intervention Tonino PAL, De Bruyne B, Pijls NHJ, Siebert U, Ikeno F, van `t Veer M, Klauss V, Manoharan G, Engstrom T, Oldroyd KG, Ver Lee PN, MacCarthy PA, Fearon WF
N Engl J Med 360:213, January 15, 2009
The presence of myocardial ischemia is an important risk factor for an adverse clinical outcome. 1 2 3 Revascularization of stenotic coronary lesions that induce ischemia can improve a patient's functional status and outcome. 3 4 5 For stenotic lesions that do not induce ischemia, however, the…

3. Prasugrel compared with clopidogrel in patients undergoing percutaneous coronary intervention for ST-elevation myocardial infarction (TRITON-TIMI 38): double-blind, randomised controlled trial
Gilles Montalescot, Stephen D Wiviott, Eugene Braunwald, Sabina A Murphy, C Michael Gibson, Carolyn H McCabe, Elliott M Antman and for the TRITON-TIMI 38 investigators
Lancet Volume 373, Issue 9665,Pages 723-731
A substudy of TRITON-TIMI 38 confirms the main trial findings that prasugrel is more efficacious but might be less safe than clopidogrel.

4. Extended-Release Niacin or Ezetimibe and Carotid Intima-Media Thickness
Taylor AJ, Villines TC, Stanek EJ, Devine PJ, Griffen L, Miller M, Weissman NJ, Turco M
N Engl J Med 361:2113, November 26, 2009
Treatment with 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors reduces low-density lipoprotein (LDL) cholesterol levels and results in clinically significant reductions in the relative risk of major cardiovascular events. 1 However, because of the residual cardiovascular risk seen with…

5. A Trial of Darbepoetin Alfa in Type 2 Diabetes and Chronic Kidney Disease
Pfeffer MA, Burdmann EA, Chen CY, Cooper ME, de Zeeuw D, Eckardt KU, Feyzi JM, Ivanovich P, Kewalramani R, Levey AS, Lewis EF, McGill JB, McMurray JJV, Parfrey P, Parving HH, Remuzzi G, Singh AK, Solomon SD, Toto R
N Engl J Med 361:2019, November 19, 2009
Type 2 diabetes mellitus and chronic kidney disease frequently coexist, and each disease independently increases the risk of cardiovascular events and end-stage renal disease. 1 2 Intensive treatment of concomitant conventional risk factors such as hypertension and elevated levels of low-density…

6.A Randomized Trial of Therapies for Type 2 Diabetes and Coronary Artery Disease
N Engl J Med 360:2503, June 11, 2009
…included study-group assignment, stratum, and assigned study group according to stratum interaction were used to determine whether the study-group effect was significantly modified by the intended method of revascularization. In addition, the statistical interactions between the cardiac study groups and the…

7. Pharmacodynamic effect and clinical efficacy of clopidogrel and prasugrel with or without a proton-pump inhibitor: an analysis of two randomised trialsMichelle L O'Donoghue, Eugene Braunwald, Elliott M Antman, Sabina A Murphy, Eric R Bates, Yoseph Rozenman, Alan D Michelson, Raymond W Hautvast, Peter N Ver Lee, Sandra L Close, Lei Shen, Jessica L Mega, Marc S Sabatine, Stephen D Wiviott
The Lancet, Volume 374, Issue 9694, 19 September 2009-25 September 2009, Pages 989-997
An observational analysis of trial data confirms the functional interaction but provides no evidence of adverse clinical effects

8. Coronary Bypass Surgery with or without Surgical Ventricular Reconstruction
Jones RH, Velazquez EJ, Michler RE, Sopko G, Oh JK, O'Connor CM, Hill JA, Menicanti L, Sadowski Z, Desvigne-Nickens P, Rouleau JL, Lee KL
N Engl J Med 360:1705, April 23, 2009
Coronary artery disease is the predominant cause of heart failure, which is a major cause of death and disability throughout the world. Evidence-based medical therapy has been shown to reduce symptoms and increase survival in patients with heart failure and coronary artery disease. 1 In addition,…

9. Effects of Exercise Training on Health Status in Patients With Chronic Heart Failure
HF-ACTION Randomized Controlled Trial
JAMA. 2009;301(14):1451-1459
Exercise training conferred modest but statistically significant improvements in self-reported health status compared with usual care without training. Improvements occurred early and persisted over time.

10.Percutaneous Coronary Intervention versus Coronary-Artery Bypass Grafting for Severe Coronary Artery Disease
Serruys PW, Morice MC, Kappetein AP, Colombo A, Holmes DR, Mack MJ, Stahle E, Feldman TE, van den Brand M, Bass EJ, Van Dyck N, Leadley K, Dawkins KD, Mohr FW
N Engl J Med 360:961, March 5, 2009
Coronary-artery bypass grafting (CABG) was introduced in 1968 and rapidly became the standard of care for symptomatic patients with coronary artery disease. 1 Advances in coronary surgery (e.g., off-pump CABG, smaller incisions, enhanced myocardial preservation, use of arterial conduits, and…

Quality Care at the End of Life

Presentations from the Palliative Care Australia Together : 2009 Conference are now available for download. "Together! Cultural connections for quality care at the end of life", was held in Perth in September 2009 and has over 50 presentations including clinical, spirituality, rural, ethical, aged, paediatric and nursing issues. Palliative Care Australia also have some excellent Resources to download.

Aboriginal spirituality: Aboriginal philosophy, the basis of Aboriginal social and emotional wellbeing

This discussion paper by Vicki Grieves of the Cooperative Research Centre for Aboriginal Health argues for the centrality of Aboriginal Spirituality in the practice of social and emotional wellbeing and for applications in all areas of Aboriginal development. Although often mentioned in the literature on Aboriginal health and social and emotional wellbeing, Spirituality has been in danger of becoming one of the undefined terms-like wellbeing, community, identity-that are used in various contexts and with various meanings attached, and in ways that obscure the reality of Indigenous Australian knowledges, philosophies and practices. In common with terms such as the Dreaming, it has lost significant meaning when translated into English.

This discussion paper importantly defines Aboriginal Spirituality by privileging the voices of Aboriginal people themselves and those of well-respected observers of Aboriginal culture. It demonstrates how those who are well exemplify Spirituality in everyday life and cultural expression. Having commonalities with international Indigenous groups, it is also deeply appreciated by non-Aboriginal people who understand and value the different ontologies (understandings of what it means to be), epistemologies (as ways of knowing) and axiologies (the bases of values and ethics) that Aboriginal philosophy embodies, as potential value to all peoples.

Spirituality includes Indigenous Australian knowledges that have informed ways of being, and thus wellbeing, since before the time of colonisation, ways that have been subsequently demeaned and devalued. Colonial processes have wrought changes to this knowledge base and now Indigenous Australian knowledges stand in a very particular relationship of critical dialogue with those introduced knowledges that have oppressed them. Spirituality is the philosophical basis of a culturally derived and wholistic concept of personhood, what it means to be a person, the nature of relationships to others and to the natural and material world, and thus represents strengths and difficulties facing those who seek to assist Aboriginal Australians to become well.

This discussion paper questions the advisability of approaches that incorporate an Aboriginal perspective or cultural awareness as an overlay to the Western practices of dealing with mental health issues. Western practices have developed out of an entirely different concept of personhood, development of the individual and relationships to the wider world, and further research in this area, particularly incorporating the voices of Aboriginal and Torres Strait Islander people, is critical to ways forward.

State of the World's Indigenous Peoples Report

Australia's Aboriginal population has the worst life expectancy rates of any Indigenous population in the world, national average for the Inuit in Canada.a UN report has found. Aboriginal Medical Services Alliance of the Northern Territory CEO John Paterson said the findings, which examined the Indigenous populations of 90 countries, were no surprise. Mr Paterson said research gathered by the Alliance, notwithstanding progress being made to improve the health of Aborigines, mirrored the UN findings. "To improve the status of Aboriginal health, one key measure or approach is for Aboriginal people to become more involved in decisions around strategies, programs in primary healthcare," he said. "It's time for governments to seriously consider handing over that responsibility to Aboriginal people." He said positive trends had emerged overseas in areas where Indigenous people were able to contribute to their local healthcare system. According to the UN report, Indigenous peoples experience disproportionately high levels of maternal and infant mortality, malnutrition, cardiovascular illnesses, HIV and other infectious diseases such as malaria and tuberculosis.

The publication's statistics illustrate the gravity of the situation in both developed and developing countries. Poor nutrition, limited access to care, lack of resources crucial to maintaining health and well-being and contamination of natural resources are all contributing factors to the terrible state of indigenous health worldwide.

According to the report:

- Life expectancy of indigenous peoples is up to 20 years lower than their non-indigenous counterparts.

- Indigenous peoples experience disproportionately high levels of maternal and infant mortality,malnutrition, cardiovascular illnesses, HIV/AIDS and other infectious diseases such as malaria and tuberculosis.

- Suicide rates of indigenous peoples, particularly among youth, are considerably higher in many countries, for example, up to 11 times the national average for the Inuit in Canada

Dental health of Australia's teenagers and pre-teen children : the Child Dental Health Survey, 2003-04(AIHW)

Teenage children have been identified as being at increased risk of dental disease, and among pre-teen children nearly half of all 6 year olds had a history of decay in their baby teeth. The Child Dental Health Survey provides national information on the dental health of children attending school dental services in Australia, and shows decay experience is relatively common in both teenage and pre-teen Australian children.

SCIE Dementia Gateway web resource

If you work with people with dementia in nursing, residential or domiciliary settings you might find this website useful. There are lots of practical tips, tools and activities, and a video collection. Each section has been written by a dementia expert and reflects best practice in dementia care.

Rating Scales for Mood Disorders

The Mood Disorders Unit (MDU) research team at the Black Dog Institute has been responsible for developing a number of rating scales. Topics covered include antenatal risk, postnatal risk, bipolar disorder, parental bonding, behavioural inhibition, anxiety and psychomotor skills.

HIV management: A guide for clinical care

The Australasian Society for HIV Medicine has updated the HIV Management:a Guide for Clinical Care monograph. This clinical resource has been extensively reviewed and updated to incorporate the latest advances and research in the management of HIV. It is an invaluable reference handbook for HIV S100 community prescribers and clinicians. The resource aims to improve the care and wellbeing of people with HIV infection in Australasia.

The 2009 edition is divided into the following three sections: mechanisms,phases and diagnostic; therapeutics and monitoring; and clinical manifestations of HIV disease.

Click here to download or order your free copy or for further information.

Reposted from NCAHS Library Clippings

Rural Health and Indigenous Health ABC Online Health and Wellbeing pages

The ABC Online YourHealth pages are a useful source for researching current health topics. Recent additions include an Indigenous Health page and a Rural Health page, both featuring articles, news stories, links, statistics and general information.

Also available are specialist pages on Men's Health, Kids Health, Women's Health and Over 50s..

There are also numerous Fact Files and Health Topics pages on individual health conditions

Expenditure on health for aboriginal and Torres Strait Islander people 2006-07 (AIHW)

The Australian Institute of Health and Welfare has released a new report : Expenditure on health for aboriginal and Torres Strait Islander people 2006-07

Expenditure on health and high care residential aged care for Aboriginal and Torres Strait Islander people amounted to $2,953 million in 2006-07,or 3% of national expenditure on health and high care residential aged care. In 2006-07, the average expenditure per person on health and high care residential aged care was $5,650 for Aboriginal and Torres Strait Islander people. For non-Indigenous people, the average expenditure per person was $4,621. The ratio of Indigenous to non-Indigenous expenditure per person was 1.22. For the Australian Government schemes of Medicare and the Pharmaceutical Benefits Scheme (PBS), total benefits paid per Aboriginal and Torres Strait Islander person were 59% of the amount spent on non-Indigenous people.

Media release

Author's comments on report