Health Report - Separate stories podcast (ABC listen)

A private hospital will soon be accepting patients, charging no out-of-pocket costs for those insured with specific private health funds. 

Adeney is the the first private hospital in Australia to offer no-gap cover from the surgeon to the pharmacy. 

So how does a model like this make money for its doctors, and are there potential conflicts of interest?

Guest/s

• Louise O'Connor, CEO of Adeney Private Hospital in Kew, Melbourne

There's been a concerning rise in depression and anxiety in adolescents, and an Australian study has reinforced the need for change.

In a survey of more than 1,200 students, aged between 10 and 18, a majority reported symptoms of a common mental disorder. And girls seem particularly vulnerable.

The researchers say that at this rate, there’s not enough support for everyone, and we need to invest more in prevention.

Guest/s

• Professor Susan Sawyer, director of the Centre for Adolescent Health at the Royal Children's Hospital 

References

• Tracking the course of depressive and anxiety symptoms across adolescence (the CATS study): a population-based cohort study in Australia

A leading youth mental health expert has pushed back at the suggestion that three quarters of adolescents in Australia have been anxious or depressed. 

While it's agreed rates of both conditions are rising among young people, there are ways to improve services so more people can access support. 

Guest/s

• Professor Pat McGorry, executive director of Orygen and Youth Mental Health at the University of Melbourne

References

• National Study of Mental Health and Wellbeing 2020-2022
• The Lancet Psychiatry Commission on youth mental health

You might associate type 1 diabetes with children, teenagers or young adults.

However in some cases this autoimmune condition can come on later in life — and this is not latent autoimmune diabetes of adults (LADA).

It can be hard to recognise, and sometimes mistaken for type 2 diabetes when there are risk factors at play like obesity.

Guests

• Daryl Mitchell 
• Professor Jonathon Shaw, Endocrinologist and Deputy Director at the Baker Heart and Diabetes Institute

References

• The epidemiology of type 1 diabetes mellitus in older adults

Changes to the Therapeutic Guidelines mean the antibiotics you get prescribed might change, including for UTIs. 

Also, another study on the shingles vaccine driving down the risk of dementia. 

And a correction — and clarification — on our story about back pain and interventions to treat it. 

References

• What's New in Antibiotic - Therapeutic Guidelines
• A natural experiment on the effect of herpes zoster vaccination on dementia - Nature
• Back pain — what works and what doesn't - the Health Report

Back pain is a common form of chronic pain – especially low back pain. And most of the time the cause is unclear.

Surgeries and injections have been used in the past but the evidence against those interventions is mounting.

So why are they still being done? And what are the evidence-based options out there for people who are struggling with back pain?

Guest/s

• Professor Rachelle Buchbinder,  rheumatologist and head of Musculoskeletal Health at Monash University

References

• Commonly used interventional procedures for non-cancer chronic spine pain: a clinical practice guideline - British Medical Journal

James Harrison died this week, but in his 88 years he saved the lives of more than two million babies through regular blood donations.

He was known as 'the man with the golden arm' because his plasma contained Anti-D.

Also, a look at some viruses transmitted by midges and mosquitoes that are spreading overseas and in Australia.

And research into potential new treatments for bacterial vaginosis.

Guest/s

• Belinda Smith, ABC Science 

References

• James Harrison's story
• Oropouche virus disease, WHO fact sheet
• Bacterial vaginosis can be sexually transmitted, less recurrence with partner treatment, study finds

Victoria’s breast screening service is starting to advise patients when they have dense breasts, urging them to discuss their cancer risk with their GP.

Western Australia and South Australia have been doing this for some years.

However there are still no national guidelines, and it’s not always clear what GPs should do with this information.

Guest/s

• Associate Professor Wendy Ingman, University of Adelaide

References

• Breast density - frequently asked questions - BreastScreen Victoria
• Dense breasts - BreastScreen WA
• Breast density - BreastScreen SA
• BreastScreen Australia National Policy and Funding Review

A new clinical toolkit has been designed to improve the management of vocal cord dysfunction.

Also known as inducible laryngeal obstruction, this condition affects about up to 70 per cent of people with chronic cough, 20 per cent of people with asthma and 10 per cent of high-level athletes.

It can be tough to diagnose and people can be put onto unnecessary or harmful treatments if it’s not identified.

Guest/s

• Robyn Baker, patient
• Professor Philip Bardin, respiratory physician at Monash University and Hospital

References

• The ILO/VCD toolkit

Labor has delivered its election-year budget, including a variety of health spending promises. 

It includes earlier promises to incentivise more bulk-billing in general practice, and rebated menopause health assessments. 

Meanwhile the Coalition is promising to up psychology sessions from 10 to 20 each year, something that was temporarily done at the height of the pandemic. 

References

• Budget documents
• Peter Dutton's budget reply  

Labor and the Coalition want to increase incentives to GPs to bulk bill, but despite this promise, it's likely not all clinics will change. 

Was it pre-emptive for the Government to suggest nine out of 10 GP visits will be free by the end of the decade?

Also, a study tells us the bare minimum we can do to achieve better health outcomes. 

References

• Minimum and optimal combined variations in sleep, physical activity, and nutrition in relation to all-cause mortality risk

It’s not always simple to find out your risk of cardiovascular disease.

Not everyone needs to – or should – undergo tests like coronary artery calcium scoring.

How do you determine what your risk is, what tests might benefit you, and importantly, when it’s best to do nothing?

Guest/s

• Professor David Peiris, chief scientist at the George Institute for Global Health

References

• Australian CVD risk calculator
• Effects of Combining Coronary Calcium Score With Treatment on Plaque Progression in Familial Coronary Artery Disease: A Randomized Clinical Trial

Our cells are smart – they’re able to get rid of damaged parts and recycle useful parts to keep us healthy.

This process seems to break down in conditions like Parkinson’s and Alzheimer’s disease, and waste accumulates.

Researchers have uncovered a critical step in the recycling process, which could be used to kickstart the process when it stalls.

Guest/s

• Professor Michael Lazarou, head of the Autophagy and Mitchondrial Quality Control lab at the Walter and Eliza Hall Institute

References

• Cellular clean-up: solving the mystery of how cells recycle - WEHI
• Structural pathway for PI3-kinase regulation by VPS15 in autophagy - Science

Last year the screening age for bowel cancer was lowered to 45, in response to the rising number of young adults being diagnosed.

Australia is among a handful of western countries highlighted in a recent study looking into this concerning trend.

So will our lowered screening age make a difference? Or do we need to focus our attention somewhere else?

Guest/s

• Professor Sandy (Alexander) Heriot, consultant Colorectal Surgeon and Director of Cancer Surgery at Peter MacCallum Cancer Centre

References

• Colorectal cancer incidence trends in younger versus older adults: an analysis of population-based cancer registry data
• National Bowel Cancer Screening Program - Health Department

It has been five years since COVID-19 was declared a global pandemic.

On the anniversary, the Public Health Association of Australia and Australasian Society for Infectious Diseases has warned we're unprepared for the next pandemic. 

Also, a projection to the year 2030 suggests our diets are only going to get worse.

References

• Fruit, vegetables and discretionary food intake in Australian adults: Past trends and predicted progress towards population preventive health targets for 2030

Contracting COVID-19 can cause metabolic abnormalities, which may contribute to things like insulin resistance and non-alcoholic fatty liver disease.

So a team of researchers wanted to find out whether vaccination against COVID-19 could have the same effect.

They tracked a small group of people as they received up to four vaccinations, comparing them to people with a mild coronavirus infection.

Guest/s

• Associate Professor Ruey Leng Loo,  Molecular Nutrition at the Australian National Phenome Centre at Murdoch University

References

• Longitudinal study on immunologic, lipoproteomic, and inflammatory responses indicates the safety of sequential COVID-19 vaccination

We could be underestimating the number of people living with diabetes by up to 35 per cent.

For a long time we've been using data from the National Diabetes Services Scheme (NDSS) to estimate prevalence – and to make decisions about diabetes healthcare.

But not everybody with diabetes signs up to this scheme.

This disparity in numbers casts doubt on the assertion that the prevalence of type 2 diabetes is trending down.

Guest/s

• Dr Alice Gibson, Research Fellow at the Leeder Centre for Health Policy, Economics and Data at the University of Sydney

References

• Is the burden of diabetes in Australia underestimated? Comparison of diabetes ascertainment using linked administrative health data and an Australian diabetes registry
• National Disability Services Scheme

Thousands of doctors in New South Wales have gone on strike demanding better working conditions. 

They're demanding an end to long shifts which put patient safety at risk, and pay parity with other states.

Also, the TGA updates its safety warnings for acne medication isotretinoin. However questions remain about how the changes can be implemented.  

References

• New safety warnings for isotretinoin (Roaccutane)

When you have dementia, being diagnosed early can help you and your loved ones manage the condition. It could also aid in treatment.

A new study has found that in some cases, weight loss and lipid changes happened up to a decade before dementia was diagnosed.

These could be early indicators that signal the need for closer monitoring.

Guest/s

• Professor Joanne Ryan, head of the Biological Neuropsychiatry and Dementia research unit at Monash University 

References

• Cardiometabolic Trajectories Preceding Dementia in Community-Dwelling Older Individuals

While Australia has so far dodged the H5N1 strain of bird flu that's been infecting humans, we're still recuperating from an outbreak of a different strain. 

If you've noticed a shortage of eggs at the supermarket, farmers are warning it's likely to persist as they rush to get their chickens back up to speed. 

Also, an update on vaccination against COVID-19 — who needs what and when. 

References

• H7 high pathogenicity avian influenza
• COVID-19 vaccine advice and recommendations

Endometriosis and polycystic ovarian syndrome (PCOS) are common conditions in women, and can be debilitating to live with.

Research suggests these women might also be at an increased risk of heart attack and stroke.

While it’s not fully known why, chronic inflammation, oxidative stress and high lipid levels might be to blame.

Guest/s

• Dr Mathew Leonardi, gynaecologist and sonologist at McMaster University Medical Centre

References

• Non-malignant gynaecological disease and risk of cardiovascular or cerebrovascular disease: a systematic review and meta-analysis

Through the gut microbiome, we're learning about how important what we eat can be for our mood and mental health. 

But there are many ways our diet can affect our brain, and there are still connections yet to be uncovered. 

A study has looked into how changing the food on your plate can even help treat depression, alongside psychotherapy and sometimes medications. 

Guest/s

• Professor Felice Jacka, founder and director of the Food & Mood Centre at Deakin University
• Dr Tetyana Rocks, dietitian and lead of the Food and Mood Academy 

References

• Diet interventions for depression: Review and recommendations for practice

All of us deal with a level of health anxiety at times, but for some people it devolves into full-blown hypochondria.

This can be so stressful that people do get sick – experiencing symptoms that can’t be explained by tests or scans.

The internet only exacerbates the issue, enabling them to Google their symptoms all hours of the day.

It's a cycle that can go on for years. But there is hope for people wanting to pull themselves out of this state of constant hypervigilance.

Guest/s

• Emma Mannering
• Professor Jill Newby, clinical psychologist at the Black Dog Institute and University of NSW
• Dr Cathy Andronis, GP and psychotherapist

References

• Health anxiety in Australia: prevalence, comorbidity, disability and service use | The British Journal of Psychiatry
• The global economic burden of health anxiety/hypochondriasis- a systematic review
• Increase in the prevalence of health anxiety in medical clinics: Possible cyberchondria
• Cognitive behavior therapy for health anxiety: systematic review and meta-analysis of clinical efficacy and health economic outcomes
• A clinician’s quick guide to evidence-based approaches: health anxiety

• Health anxiety information and workbook

High temperatures are linked to an increased risk of heart attack and stroke, so what does that mean for a country set to experience more extreme maximums under climate change?

A new study has looked at what could happen into the 2050s, and how the impact of hot weather on cardiovascular disease can be combated. 

It requires policy change, and a shift to helping the most vulnerable people in our communities cope with the heat. 

Guest/s

• Professor Peng Bi, Public Health at the University of Adelaide

References

• High temperature and cardiovascular disease in Australia under different climatic, demographic, and adaptive scenarios

A look at some of the Health Report correspondence this week.

You can email us at healthreport@abc.net.au

A look at some of the Health Report correspondence this week.

You can email us at healthreport@abc.net.au

A look at some of the Health Report correspondence this week.

You can email us at healthreport@abc.net.au

A look at some of the Health Report correspondence this week.

You can email us at healthreport@abc.net.au

A look at some of the Health Report correspondence this week.

You can email us at healthreport@abc.net.au

A look at some of the Health Report correspondence this week.

You can email us at healthreport@abc.net.au

A look at some of the Health Report correspondence this week.

You can email us at healthreport@abc.net.au

A look at some of the Health Report correspondence this week.

You can email us at healthreport@abc.net.au

A look at some of the Health Report correspondence this week.

You can email us at healthreport@abc.net.au

References:

• This under-tested type of blood fat could be driving heart disease

Community control of health care has been hard fought in Indigenous communities, and it's delivering results.

In their book First Knowledges Health: Spirit, Country and Culture, Shawana Andrews, Sandra Eades and Fiona Stanley map the history and importance of this movement.

They also outline how returning to traditional ways of life can improve outcomes through nutrition, activity and community engagement.

Guest/s

• Professor Sandra Eades, epidemiologist and Deputy Dean, Indigenous Medicine, Dentistry and Health Sciences
• Professor Fiona Stanley, Distinguished Research Professor in the School of Paediatrics and Child Health at the University of Western Australia

Joint replacements are life-changing for many people who’ve been dealing with chronic pain and disability.

However the materials used for these replacements are subject to wear and tear.

More attention is being paid to the potential toxic effects of metal joint replacements when they start to break down.

Also, Professor Smith talks about his decision to resign from Canberra Hospital. 

Statement from Canberra Health Services:

Canberra Health Services has introduced an escalation pathway which makes the Clinical Director for Surgery the final decision maker where there is a difference of opinion between a surgeon and the Operations Centre.

This ensures that there is a senior, independent clinician as the decision maker when there is a disagreement between specialties, as can sometimes happen with access to theatres.

CHS recognises the critical importance of surgeons’ clinical decision-making and encourages all CHS surgeons to discuss their concerns with the Clinical Director.

CHS will continue to work with surgical teams and senior doctors to address concerns about the implementation of the Integrated Operations Centre to ensure it is achieving the best outcomes for patients.

Guest/s

• Professor Paul Smith, orthopaedic surgery at ANU Medical School and clinical director of the National Joint Replacement Registry

References

• Metal Concentrations in Blood and Cerebrospinal Fluid of Patients With Arthroplasty Implants

As the US deals with a worsening measles outbreak, we’re also grappling with a rise in cases here.

While travellers have been put on alert, not all cases are from people returning from overseas. People are contracting measles here as well.

There has been a decline in the number of children getting immunised against the virus since 2020.

What’s behind the trend, and what will happen if it continues?

Guest/s

• Dr Linny Phuong,  paediatric infectious diseases physician at the Royal Children’s Hospital, Cabrini Health and Murdoch Children’s Research Institute

There are currently more than 200 shortages of medications, including some forms of menopause hormone therapy, ADHD medication and birth control. 

It's not always clear why some medications are in short supply, but sometimes the shortage can be traced all the way to a farm in China. 

Also, why US President Donald Trump wants to target Australia's Pharmaceutical Benefits Scheme (PBS). 

References

• Medicine shortage reports database - TGA
• Understanding the impact of medicine shortages in Australia Discovery report

New research is revealing that what is sometimes known as a 'mini' or 'minor' stroke is not minor at all. 

A study has found after one of these attacks, your risk of a regular stroke and further harm is much higher. 

It highlights the need for more support for patients after they've had an attack, which could warn of more to come. 

Guest/s

• Professor Stephen Davis, director of the Melbourne Brain Centre at the Royal Melbourne Hospital and University of Melbourne. 

References

• Long-Term Risk of Stroke After Transient Ischemic Attack or Minor StrokeA Systematic Review and Meta-Analysis
• Optimised medical therapy alone versus optimised medical therapy plus revascularisation for asymptomatic or low-to-intermediate risk symptomatic carotid stenosis (ECST-2): 2-year interim results of a multicentre randomised trial
• Cognitive Decline After First-Time Transient Ischemic Attack

Scientists have long been aware of a paradox of neurodegenerative disease – that as the brain deteriorates, in some patients creativity flourishes.

Researchers have used imaging techniques to map creativity in the brains of people with neurodegenerative diseases like Parkinson’s and Alzheimer’s.

They’ve found that the shutting down of specific connections related to inhibition boosts creativity.

Guest/s

• Dr Isaiah Kletenik, Assistant Professor at Harvard Medical School and neurologist at Brigham & Women's Hospital

References

• Mapping Neuroimaging Findings of Creativity and Brain Disease Onto a Common Brain Circuit

More than 2.2 million Australians are dealing with osteoarthritis, and many struggle to access the right information about the condition.

A new website has launched to connect people with the tools they need to manage osteoarthritis – and hopefully improve their quality of life.

Also, could the new generation of weight loss drugs help with this management?

Guest/s

• Professor David Hunter, rheumatologist and clinical researcher at the University of Sydney

References

• MyOA - Osteoarthritis support
• Precision weight management in people withknee osteoarthritis and overweight or obesity - Nature
• The Osteoarthritis Prevention Study (TOPS)

Australian researchers are a step closer to proving the safety of some medications that can help pregnant women quit smoking. 

They've looked back at women who used nicotine replacement therapy (NRT), varenicline and bupropion during the first trimester of pregnancy. 

The drugs are not associated with an increased risk of major congenital malformations. 

Guest/s

• Dr Duong Tran, Research Fellow at the National Drug and Alcohol Research Centre, UNSW 

References

• Risk of Major Congenital Malformations Following Prenatal Exposure to Smoking Cessation Medicines

As women get older, the risk of pelvic floor prolapse increases, and it can severely impact their quality of life. 

A new study has looked at the clitoris following prolapse surgery, to begin to uncover what's required to maintain or restore sexual function after the procedure. 

Guest/s

• Professor Helen O'Connell, Director of Surgery and Head of Urology at Western Health in Melbourne

References

• Postoperative Sexual Function After Vaginal Surgery and Clitoral Size, Position, and Shape
• Rediscovering the Clitoris—Sexual Function After Transvaginal Surgery - Invited Commentary

Draft guidelines have been published to account for the changing world of prostate cancer screening. 

But a full screening program hasn't been established, because of flaws in the PSA test, and the risk of causing more harm than good. 

References

• Prostate Cancer Foundation of Australia - draft guidelines

Robert F. Kennedy Jr has been confirmed as President Trump's secretary of the Department of Health and Human Services. 

This is despite his contentious views on things like vaccination and anti-depressants.

President Trump has already overseen major cuts to America's research sector, with concerns labs could close without appropriate funding. 

References

• 'Devastating' cuts to NIH grants by Trump's team put on hold by US judge - Nature
• Supplemental Guidance to the 2024 NIH Grants Policy Statement: Indirect Cost Rates

Substituting your table salt for something with lower sodium could improve your heart health.

Most salt substitutes are made of potassium chloride, which has recently been shown to reduce the chance of recurrent strokes.

Despite this, not everyone should be reaching for potassium chloride. And not everyone can afford to.

Guest/s

• Professor Bruce Neal, executive director of The George Institute for Global Health

For many people, GLP-1 agonists like Ozempic or Wegovy have been a game-changer for weight loss.

It has long been recognised in the field of obesity research that before these drugs came onto the market, there were very few interventions that worked.

Things have changed fast, so what do you need to know about this new class of drugs if you’re considering taking them?

Guest/s

• Associate Professor Samantha Hocking, endocrinologist at the Royal Prince Alfred Hospital and University of Sydney

References

• Mapping the effectiveness and risks of GLP-1 receptor agonists - Nature

If you’re like thousands of other Australians you’ve watched the new series on Belle Gibson, agape at the misinformation she spread on social media.

Since she was exposed in 2015, platforms like Instagram have only grown, and popular users have only gained influence over their followers.

A new study has looked into posts full of misleading information about things like full-body MRI scans and early detection cancer tests.

Guest/s

• Dr Brooke Nickel, public health researcher at the University of Sydney

References

• Social Media Posts About Medical Tests With Potential for Overdiagnosis

Briefly checking in with students about their mental wellbeing throughout the school year could reduce distress.

In a trial involving over 10,000 Australian students, an online screening survey led to improved outcomes.

Information about their mental wellbeing was passed on to caregivers, catching kids who might otherwise fly under the radar.

Guest/s

• Alana Koch, head of wellbeing at St Luke's Grammar School
• Professor Ron Rapee, Distinguished Professor of Psychology at Macquarie University

References

• My Mind Check

• A Cluster Randomized Trial of the Impact of School-Based, Universal, Mental Health Screening and Feedback on Students' Mental Health and Help-Seeking

A new report has exposed how some manufacturers of toddler foods use marketing to sell unhealthy foods to busy parents. 

Also, a convincing study on replacing salt with potassium for cardiovascular health. 

And a concerning study about cannabis use disorder and schizophrenia in a country where weed has been legalised. 

References

• Confectionery is being marketed to parents as nutritious toddler food, report finds
• Salt Substitution and Recurrent Stroke and Death: A Randomized Clinical Trial | Cerebrovascular Disease
• Sodium Reduction Legislation and Urinary Sodium and Blood Pressure in South Africa
• Cannabis and schizophrenia incidence

With a new generation of weight loss drugs flooding the market, what is being done to safeguard people with eating disorders?

There are concerns people of a higher weight with restrictive eating disorders could access GLP-1s if doctors aren’t screening patients appropriately.

And this is partly due to the belief that people with restrictive eating disorders like anorexia are always underweight.

Guest/s

• Dr Sarah Trobe, National Eating Disorder Collaboration

References

• Management of eating disorders for people with higher weight: clinical practice guideline

Eating disorder resources:

• The Butterfly Foundation on 1800 33 4673 or webchat.
• Eating Disorders Foundation Victoria
• Eating Disorders Families Australia — 1300 195 626
• Professionals Credentialed in Eating Disorders
• Lifeline on 13 11 14
• Kids Helpline on 1800 551 800