August Policy and Research Update No Images? Click here Research & Policy UpdateWelcome to the August research and policy update. It has been a busy month for the Research and Policy unit progressing the national telehealth trial, convening a meeting of the RFDS Clinical and Health Services Research Committee, and progressing a collaborative end-of-life care project with Palliative Care Australia. We are continuing work on two research papers focused on cardiovascular health within the RFDS and the development of the RFDS Service Planning and Operational Tool (SPOT). The telehealth trial, in conjunction with the University of Queensland commences on 1 September 2017. Every 30 days, one of the 14 clinics participating in the trial will commence offering telehealth in addition to their usual face-to-face services. It is a collaborative effort and we thank the RFDS Sections and Operations that are participating in the trial. Cresley is now managing the compilation and distribution of this update. If you have any queries, or recommendations for content, please email Cresley at cresley.wheeler@rfds.org.au. Lara, Andy and Cresley Peer reviewed researchPre-hospital and retrieval medicine: clinical governance and workforce models Contributions to the pre-hospital area cover seven distinct clinical groups, and the challenge is to match skill and capabilities to patient groups allowing better health systems. Interdisciplinary learning and professional development is fundamental to quality clinical sets and allows paramedicine and doctors to form partnerships. Stroke epidemiology in an Australian rural cohort (SEARCH) Australian stroke rates have been declining since 1990, based on urban studies. Data from five rural centres found a crude rural stroke rate of 113 people per 100,000 population per year. Of those first time incidence, the crude stroke rate was 50 people per 100,000 population confirming the decline of stroke incidence. Analysis showed that in Ireland, 2.36% of variation in incidence ratio was due to urban-rural classification. OHCA variation is almost fully explained by area-level deprivation and proximity to ambulance stations. Local differences in policy, practice and resources occur for the optimal use of AMs to reduce AM-resistant organisms. The most common interventions were dissemination of educational material (62%), expert approval (61%), audit and feedback (55.1%), educational outreach (53.7%) and compulsory order forms (51.5%). Bored reading science? Let’s change how scientists write This paper promotes a change in the way scientists write to become more engaging to the reader. The changes suggested include the use of narrative, in order to engage a wider audience than scientists, rather than the “official style” that is entrenched in history, described as often “boring and hard to read”. Improvements in rural oral health can be achieved by building oral health capacity of non-dental care providers. Many rural residents present to PC providers for management of short-term pain relief and antibiotics. The management of dental problems was restricted by limited communication with visiting dental practitioners. This study found that middle-age and older patients are more likely to use telephone triage advice service. Compliance with that advice is unknown. Knowledge of those who are less likely to comply with telephone triage advice may assist in refining triage protocols and referral pathways for optimal patient compliance. Specialist outreach services in regional and remote Australia: key drivers and policy implications This investigation found access to a core group of regionally based specialists who can address the bulk of community demand was more desirable than universal access.This allows improved local treatment options for small populations often have the highest burden of disease and least local health services available. Data from the last 50 years showed the majority of deaths (88%) were from natural causes (chronic lung disease, cardiovascular disease and renal failure). The rates of natural deaths have been falling since 1986, mostly from the >45yo group, attributed to improved health policy and service delivery. This epidemiological survey measured service use for mental health reasons among Indigenous populations compared with the general population. Service use was greater when targeted Indigenous specific content was included. Identifying and avoiding bias in research The BIRCH project compares traditional CV risk stratification with novel markers such as sleep quality, left ventricular function and morphology, and lipidomic profiling of risk to more accurately predict CV disease. Limited access to services has prevented widespread use of CT for SZ patients. Delivering CT remotely to people with SZ using iPads is feasible and results in improved retention rates, adherence, and cognitive and functional outcome improvements that are comparable with CT delivered in the laboratory. Clinicians, non-clinical support staff and managers were consulted on their understanding of clinical governance, with approximately one third unsure of its meaning. This study found high variability in the understanding and use of clinical governance in rural and remote practices, resulting in a lack of clinical governance. Arteriosclerosis is a contributor to cardiovascular disease (CVD) and is easily quantified by measurement of blood pressure (BP), however there is no guideline on the diagnostic level of difference in BP. Of the seven factors reviewed, inter-arm difference was the strongest predictor of CV events. Recent policy proposals & reformIncreased youth focus as Minister Wyatt co-chairs suicide prevention committee The recommendations from this committee include: mentoring for young leaders, teaching local culture and traditions in schools, strong networking opportunities through sport and cultural activities, “safe houses” and care coordinators employed by Aboriginal community groups. New East Arnhem Land aged care service to create jobs Community consultation is currently underway (until December 2017) to involve locals in creating job opportunities and the best service model to meet East Arnhem Land’s needs. This service will provide residential care and support to older Indigenous people so they can stay close to community and country. Broken Hill hosts nation’s 100th headspace youth mental health service This is a community led, mental health not-for-profit organisation, targeting the high rates of self-harm and suicide and Indigenous mental health issues. This service will offer early intervention support to young people 12 to 25 years in the Broken Hill area. Programs paving way for healthy future in Broken Hill and the far west A 10-year evaluation of the Chronic Disease Strategy, showed programs are reducing diabetes and heart, kidney and lung disease, and improving preventive health care. This initiative has doubled the number of annual health checks every year, and quadrupled the number of health checks for children under 15. Ministerial dementia forum report This report highlights that effective and accessible dementia support must be closely integrated with the broader aged care, health and social service systems to improve support for people living with dementia. The Royal Children’s Hospital is leading research with its BRAIN AIM programme, which aims to improve survival rates of childhood brain cancer rates. Brain cancer is the leading cause of death in under 25s, and has a 5-year survival rate of 22 per cent. New campaign to encourage parents to ‘get the facts about immunisation’ Immunisation rates in Australia indicate over 93% of five-year old children are fully vaccinated. There are some areas of lower rates, which poses a risk for those too young or unable to immunise. This campaign aims to provide evidence based information to support decision making around immunisation. Historic medical breakthrough by Australian researchers NHMRC funding for the Victor Chang Research Institute has supported a 12 year study finding vitamin B3 can cure a deficiency in a molecule which can lead to miscarriage and many types of birth defects. Record number of Australians receiving Medicare benefits More Australian patients are seeing their doctor without having to reach for their wallet with GP bulk billing rates for the 2016-17 financial year increasing to 85.7% compared to 85.1% in 2015-16. Doorstop - COAG health council, Brisbane The Fifth National Mental Health and Suicide Prevention Plan was approved by all states. This Plan covers eating disorders, early intervention for under 16s, and linkage services post discharge from hospital, where people are most vulnerable. A Medicare item number will be created for treatment of eating disorders. Approval of “The Heart of Australia” was announced, with $1 million of funding towards a 25 metre-long custom-designed clinic-on-wheels, reducing the gap in service provision between urban and rural populations. The service is providing specialist services in rural areas where there are no other service options exist. Making more life-changing medicines available to all Australians Almost half a billion dollars’ worth of new PBS medicines, have been listed providing access to life-changing drugs. Stelara® for treatment of severe adult Crohn’s disease. Zydelig® will be available to treat certain types of leukaemia. Somavert® is available for treatment of Acromegaly. What's new?Australian Indigenous HealthInfoNet publishes a peer-reviewed electronic journal, called HealthBulletin, which provides new information about research of relevance to the health of Aboriginal and Torres Strait Islander peoples. This is a comprehensive resource that may be of interest to RFDS staff. The AIHW released the following updated in August: · GEN-erational change as aged care data access is made easier for all · National Social Housing Survey: detailed results 2016 (Cat. no. HOU 290) · Radiotherapy in Australia 2015–16 (Cat. no. HSE 191). The NHMRC released the following updated in August: NHMRC and other Australian government priorities: the 5 top areas of funding expenditure in 2016 were cancer, CVD, mental health, diabetes, ATSI health. The ABS released the following updates in August: · Population by age and sex, regions of Australia, 2016 (Cat. no. 3235.0) · Regional population growth, Australia, 2016 (Cat. no. 3218.0) · Census of population and housing: families with school children, · Overseas arrivals and departures, Australia, Jun 2017 (Cat. no. 3401.0) · Average weekly earnings, Australia, May 2016 (Cat. no. 6302.0) · Selected living cost indexes, Australia, Jun 2017 (Cat. no. 6467.0). 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