Mining brings HIV boom?
One thing the mining boom might bring to WA is more HIV – by two routes. Men in their 40s who acquire infection overseas (hormones and bulging wallets on the rampage) and fast-tracked 457 visa imported workers who are not required to be pre-tested for HIV. Although numbers are small (around 75/yr), there has been a 30% increase in HIV notifications in the last 2 years.
Nurses find new teams
The word “autonomous” has been replaced with “collaborative” for the work of the Nurse Practitioner, if amendments to the Midwives and Nurse Practitioners Bill 2009 that gives NPs access to the MBS and PBS schemes go ahead. NPs and midwives will need to enter into a “collaborative arrangement with one or more medical practitioners”. The RACGP support it and the AMA claims a negotiating win. Now it is all “teams” and NPs are in there. How this plays out is anyone’s guess as the RACGP and AMA sit down to develop a model for the “collaborative arrangements” in general practice. What about remote regions where there is no doctor within cooee?
Folic-asthma firestorm
An Adelaide study recently linked folic acid supplements late in pregnancy with allergic asthma in offspring. Uptake of this story by websites was phenomenal. The information often missing from reports was that asthma was diagnosed from a doctor interpreting a maternal-completed questionnaire and that folate supplementation in late pregnancy was associated with a childhood asthma relative risk at 3.5 years of only 1.26 (95% confidence interval: 1.08, 1.43) and the association lost statistical significance at 5.5 years. We are talking 50 or so children from 557 mothers. The researchers said this supported previous observations that folate supplementation in pregnant mice leads to an allergic asthma phenotype via epigenetic mechanisms.
Gut feeling
It’s on again – the national Bowel Cancer Screening Program. Over 100,000 people were sent potentially dud test kits between 1.12.08 and 11.5.09, with false negatives likely. They are being reissued with kits at home but will anyone take notice? Latest figures show poor participation in the program and low follow-up rates for positive results. Of the 686,000 people invited in the target age ranges of 50, 55 and 65 to participate in the screening program, only 36.6% accepted. And of the 16,436 people who returned a positive FOBT (with 83% asymptomatic), 42.9% had a GP visit recorded and 64.5% had underwent colonoscopy. Gut Foundation people say we are not doing enough.
New psych IC unit opens
WA now has its first psychiatric intensive care unit for the elderly with dementia, namely those with Behavioural and Psychological Symptoms of Dementia (BPSD). Its eight beds, cost $108,000 to refurbish, and has two large garden areas and spacious activity rooms. The pollie opening the unit mentioned figures for dementia that had patient numbers growing in WA from about 2,400 now to 11,000 by 2050. Head of Selby Older Adult Mental Health Service Dr Angela McAleer then outlined how BPSD occurs in about 90% of those who develop dementia, and significantly affects the quality of life for patients, their families and carers. The multi-disciplinary team approach is best to set up routines tailored to each patient. This “centre of excellence, contributing to training and research in the area” will be very busy.