A TEAM of junior medical officers (JMOs) at St Vincent’s Hospital in Sydney are stepping forward to offer mental health support to their colleagues, following training with public insurer iCare.

Dr Jessica Green, an experienced emergency physician who leads JMO and undergraduate teaching at the hospital, said the group of JMOs, dubbed the “Rainbow Residents”, were a diverse group who had volunteered to provide regular support to their peers.

“A new initiative will see them participate in mental health training so that they can be more aware of colleagues who may be struggling at work, and then help them access support,” said Dr Green.

Data from the Australian Bureau of Statistics suggest that 45% of Australians encounter a mental health issue during their life, and that their workplaces can provide them with vital early supports.

“We encourage all our staff to share their perspectives and experiences at work, in order to truly understand and support each other’s wellbeing,” said Dr Green.

“The peer-to-peer mental health training will ensure our junior doctors can thrive at work, by breaking down stigmas and holding positive discussions about mental health.”

The training was delivered by iCare’s Injury Prevention Manager Jen Cameron, who said the aim of all peer-based support programs was to spark early interventions, that reduce mental health pressures on staff.

“Peer support programs in workplaces offer people at risk of a mental health problem a way to connect with colleagues and seek the support that they need,” she said.

“This isn’t a silver bullet to stop all forms of mental illness, but it can deliver the first step in seeking help and to create a safe space to feel supported,” said Jen Cameron.

“Physical symptoms that manifest slowly over time – like trouble sleeping, feeling constantly flat or fatigued, or a lack of appetite – can sometimes point to a hidden psychological risk. Having trained peer supporters in a workplace can help individuals to identify pressures and take action.”

Employers and organisations who are interested in learning more about the mental health training delivered through iCare can seek advice at prevent@icare.nsw.gov.au

Who is most likely to get long COVID?

Symptoms of long COVID are more frequently reported by women, those with poor overall health before the pandemic, and those aged 50–60 years, according to a study published in Nature Communications. The findings are based on data from longitudinal surveys and electronic health records in the UK. Long COVID, also known as post-acute COVID syndrome, is commonly defined as having one or more symptoms of COVID-19 4 weeks after infection. The syndrome has been widely reported but the incidence and risk factors for the condition are not well understood. This is partly because the symptoms used to define long COVID often vary between studies, which are based on relatively small samples, and may not be generalisable to the wider population. To investigate instances of long COVID, the researchers from King’s College London used data from 6907 individuals with self-reported COVID-19 from ten population-based longitudinal health surveys in the UK that had been established before the pandemic. In parallel, they also used data from electronic health records collected by spring 2021 for 1.1 million individuals diagnosed with COVID-19. They found that the proportion of presumed COVID-19 cases in the longitudinal surveys reporting symptoms for longer than 12 weeks ranged from 7.8% to 17%, with 1.2–4.8% reporting “debilitating” symptoms. Additionally, they found that in the electronic health records only 0.4% of COVID-19 cases had a subsequent long COVID-related diagnosis or referral; however, they note that diagnostics codes had only been introduced for long COVID in health care settings in December 2020. Although the reporting of long COVID varied across studies, the authors suggest an increased risk of long COVID was associated with increasing age up to age 70 years. Female sex, poorer pre-pandemic mental health and overall health, obesity and having asthma were also identified as risk factors in both longitudinal studies and health records. The authors cautioned that while causal inferences cannot be drawn, their findings highlight the need for further research into at-risk groups. They also suggested additional representative population-based studies to improve estimates and assist health care planning are needed.

Smarter scans help blood cancer patients

A clinical trial led by the Peter MacCallum Cancer Centre has found combination fluorodeoxyglucose (FDG) positron emission tomography (PET) and computed tomography (CT) scans are better at investigating the causes of prolonged fever in patients with blood cancer than conventional CT scans. The randomised multicentre trial, published in The Lancet Haematology, found patients who were given a combination FDG-PET/CT scan instead of a conventional CT scan were able to be given more targeted treatments. This reduced the use of broad-spectrum antibiotics and also time spent in hospital. A combination FDG-PET/CT scan is a combined FDG-PET scan which produces images of how organs or tissues inside the body use sugar, a key fuel for the body’s organs, with a computed tomography (CT) scan which provides more anatomical information. FDG is the sugar compound used as the radioactive tracer in the PET scan. Prolonged or recurrent fevers are a serious problem for patients with blood cancer because they often have low levels of neutrophils – a type of white blood cell – that help them fight off infection. Without enough of these defender cells, a fever left untreated can quickly lead to sepsis and even death. Without a clear diagnosis, patients will often be given a protracted course of broad-spectrum antibiotics, which heightens their risk of developing antibiotic resistance, and can also do long term harm to their gut microbiome. “It’s both better for the patient and the health care system if we can pinpoint what is causing a fever so we can optimally treat it, and not use unnecessary broad-spectrum antibiotics,” says Professor Karin Thursky, a senior investigator on the trial. The researchers conducting the trial also found the patients who were given a combination FDG-PET/CT scan had a shorter stay in hospital. It also reduces their risk of health care-associated complications and the cost of their care.

Traffic-related fatalities, injuries biggest killers of young people

Research led by UNSW Sydney shows traffic-related fatalities and injuries are the biggest killers of young people worldwide, causing more deaths than communicable and non-communicable diseases or self-harm. The study, published in The Lancet Public Health, is the first global analysis of transport and unintended injury-related morbidity and mortality of young people aged 10–24 years. Using the latest data from the Global Burden of Disease (GBD) 2019 Study, the researchers analysed deaths and disability-adjusted life years (DALYs) from transport and unintentional injuries in adolescents across 204 countries in the past three decades. They found that despite transport injury death rates falling by a third since 1990, the number of deaths attributed to road fatalities for adolescents still increased in some countries. According to the research, reductions in transport injury and death rates in high income countries have slowed in the most recent decade. They dropped just 1.7% a year between 2010 and 2019 compared to the fall of 2.4% a year between 1990 and 2010. Adolescents are particularly vulnerable to injury risk due to increasing independence and risk-taking tendencies. However, there has been little research to date that has examined injury patterns in this vulnerable age group. There is also a growing burden of transport injuries in low income countries, where the proportion of deaths almost doubled from 28% in 1990 (74 713 of 271 772) to 47% in 2019 (100 102 of 214 337). Graduated driver licensing, minimum drinking age laws, lower blood alcohol content levels for novice drivers, seat belt and helmet laws, and school zones have all shown to be effective in reducing injury-related harms when imposed. All-age interventions such as speed enforcement and drink driving enforcement are also effective in reducing road traffic deaths. The research also recommends promoting active transport infrastructure to prioritise alternative travel options and designing streets with the road safety needs of children and adolescents at the forefront of the planning.

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