Common sense endures
New WA legislation that allows adults to make an Advance Health Directive – a legal document in which an adult with full legal capacity outlines future treatment options – came into effect last month. It will also allow for Enduring Powers of Guardianship where an adult can legally appoint someone to make decisions for them should they lose their capacity to do so through accident or illness. Medical Forum covered these issues as far back as July 2008, so introduction of legislation is long overdue. Health professionals can find out more via the public inquiry lines (9222 2300 and 1300 858 455).
A bit of a swine
GPs will soon be ordering this year’s flu vaccine, which covers the swine flu strain and two others. Under fives are uniquely targeted with free vaccines by WA Health, hoping to reduce flu complications and hospitalisation (139 admissions last year), if parents bring their toddlers. Coordinator with the Communicable Disease Control Directorate, Dr Paul Effler, said WA is the only state taking this proactive approach and he hopes parents of children age 6 months to 4 years will contact their doctor when vaccines become available in mid-March. Panvax, which only protects against the H1N1 virus, is still available from GPs for all adults and children aged over six months (but only ~13% of the population has been vaccinated so far).
The Australian Research Council has awarded $200,000 to UWA medical physicist Vincent Wallace see if T-rays can usefully assess burns and superficial cancers. Non-ionising T-rays or terahertz radiation, combined with optical coherence tomography (OCT) could give us enhanced cross-sectional high-resolution scans of tissues, to detect early cancers (e.g. better than MRI). T-rays sit between infrared light and microwave electromagnetic radiation and they have been used since the 1990s in airport security because they can spot weapons, even plastic ones, through any concealing material.
A growing number of families are wheeling around frail granny and wondering what obstacles will befall them as they venture out. They can now refer to www.accesswa.com.au where 36 local governments, the Disability Services Commission and over 2000 businesses have joined to give searchable information on parking, toilet facilities, wheelchair access and other amenities at various recreational venues in WA. This is important to people with disabilities who now make up 50% of those over 60 years. Going to the shops, having a meal at a café, picnicking in a park or going on a holiday will be made easier.
WA’s McCusker Research Unit for Alzheimer’s Disease headed by Prof Ralph Martins is one of ten units worldwide conducting a study into early onset Alzheimer’s (i.e. < 60 years of age). They are looking to recruit into the study two or more family members affected over two generations. As well, Federal Minister for Ageing Justine Elliot has allocated $1.2m over 3 years to Curtin Uni to establish one of five national Dementia Training Study Centres to help educate undergraduates to health professionals who deal with people suffering dementia.
With over 10,000 people in Australia receiving dialysis and hospital dialysis accounting for 12.6% of all admissions, government may be keen to encourage home dialysis, especially since some claim it halves cost to about $45,000 p.a. per person compared to hospital treatment. One problem with home dialysis is the high consumption of water and electricity, so government is being lobbied to cover the extra cost. Another idea in early development is a portable kidney, or 5kg mobile dialysis unit, worn as a belt.
Sleep in the news.
Manufacturer of sleep apnoea equipment, Resmed, has announced “Australia’s first Sleep Trials Registry” which is nothing more than an opt-in register of people in north Sydney already on CPAP to “participate in product trials and evaluation”. Guess what? “users of non ResMed equipment are also welcome”. On another tack, the National Prescribing Service has been promoting a new clinical program that discourages drug therapies as first-line treatment for insomnia (currently prescribed in 95% of insomnia presentations). Dependency and adverse events in the elderly are particular concerns.