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Preference: Statistics, epidemiology and research design

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[Comment] A better world towards convergence of longevity?

Forecasting life expectancy by age and sex is broadly used for research and planning of health sevices, social services, pensions, and economics, and has been developed at the national and multicountry levels.1–3 The basic idea for predicting life expectancy is closely related to the concept of epidemiological transition.4 However, the idea is neither entirely based on evidence nor well-defined methodologically.2 Improvement in life expectancy is achieved through reductions in infant and younger age mortality and the progressive delay of mortality among older people.

News briefs

Ice use adds up to 150 000 emergency room visits a year

Methamphetamine use adds between 29 700 and 151 800 additional emergency department visits in 1 year, according to researchers from Curtin University, the University of New South Wales, the University of Newcastle and Monash University. The study, published in Drug and Alcohol Review, estimated past year rates of health service utilisation (number of attendances for general hospitals, psychiatric hospitals, emergency departments, general practitioners, psychiatrists, counsellors or psychologists, and dentists) for three levels of methamphetamine use (no use, < weekly, ≥ weekly) using panel data from a longitudinal cohort of 484 dependent methamphetamine users from Sydney and Brisbane. “We estimate methamphetamine use accounted for between 28 400 and 80 900 additional psychiatric hospital admissions and 29 700 and 151 800 additional emergency department presentations in 2013,” the researchers wrote. “More frequent presentations to these services were also associated with alcohol and opioid use, comorbid mental health disorders, unemployment, unstable housing, attending drug treatment, low income and lower education.” They concluded that: “Better provision of non-acute health care services to address the multiple health and social needs of dependent methamphetamine users may reduce the burden on these acute care services.”

Mapping malaria drug opens new possibilities

International research led by the Walter and Eliza Hall Institute of Medical Research (WEHI) has for the first time mapped how one of the longest-serving malaria drugs works, opening the possibility of altering its structure to make it more effective and combat increasing malaria drug resistance. The study, published in Nature Microbiology, produced a precise atomic map of the frontline antimalarial drug mefloquine, showing how its structure could be tweaked to make it more effective in killing malaria parasites. The team used cryo-electron microscopy, which produces images of biological molecules in their natural state in unprecedented detail, to see exactly how and where the drug binds the malaria parasite. Mefloquine has been associated with some serious side effects, including neurological symptoms. Dr Wilson Wong, from WEHI, said that the detailed atomic map would enable future drug improvements. “We now know mefloquine binds to a hotspot of activity on the ribosome surface,” he said. “However, our map of the ribosome and drug-binding site showed the fit is not perfect. We were able to mimic this interaction with compounds that were able to block the protein machinery and kill the parasite more effectively.”

Doctors not rushing to retire

Older doctors are not so keen to retire early, a new study has found.

Research conducted by Flinders University, the University of NSW, and the University of Sydney and published recently in the Medical Journal of Australia, found that more than a third of doctors aged 55 or over are not intending to retire any time soon – or they are not sure about it yet.

Their sense of purpose and the mental stimulation the job provides is keeping them at work, according to the study.

The findings are from the study’s online questionnaire conducted in 2015 of currently practising Australian doctors of that age.

Of the total respondents, 62 per cent said they intended to retire, 11.4 per cent had no intention of retiring, and 26.6 per cent were unsure. 

A total of 398 doctors (out of 1018 surveyed) stated they did not intend to retire, or were not sure about it, and 87.7 per cent of those said they strongly agreed or agreed that the cognitive stimulation of being a doctor was an important factor.

Chris Johnson

 

Prime Minister has prizes for our best scientists

The search is on again.

Each year the Federal Government honours Australia’s best scientists, innovators, and science teachers through the Prime Minister’s Prizes for Science.

The call has gone out for nominations for this year’s humble science heroes, promising early-career researchers, media-shy innovators, and modest teachers who deserve to have their work recognised on the national stage.

This is what they’re looking for:

·         heroes of Australian science who have made a significant contribution to the advancement of knowledge through science — people like Rick Shine, Graham Farquhar and Ingrid Scheffer:

·         exceptional innovators from both industry and research who have translated scientific knowledge into substantial commercial impact — like Michael Aitken, Colin Hall, Graeme Jameson, John O’Sullivan and Ian Frazer:

·         early to mid-career scientists whose research is already making, and will continue to have, an impact on our lives — like Kerrie Wilson, Jane Elith, Ryan Lister, Andrea Morello, Angela Moles, Matthew Hill and Tanya Monro: and

·         science teachers—primary and secondary — like Suzy Urbaniak, Ken Silburn, Richard Johnson and Rebecca Johnson, who are inspiring the next generation with a love of science and exploration.

The prize recipients will receive national recognition and meet leaders in science, industry, education and government at the prize dinner in the Great Hall of Parliament House, Canberra.

The prizes are:

·         $250 000 Prime Minister’s Prize for Science;

·         $250 000 Prime Minister’s Prize for Innovation;

·         $50 000 Prize for New Innovators;

·         $50 000 Frank Fenner Prize for Life Scientist of the Year;

·         $50 000 Malcolm McIntosh Prize for Physical Scientist of the Year;

·         Prime Minister’s Prize for Excellence in Science Teaching in Primary Schools ($50 000 shared between the recipient and their school); and

·         Prime Minister’s Prize for Excellence in Science Teaching in Secondary Schools ($50 000 shared between the recipient and their school).

Nominations close at 5.00 pm Canberra time, Wednesday 12 April 2017.

It’s simple to nominate in the first (shortlisting) stage, with an online form that requires:

·         details of the nominator, nominee(s), two supporters;

·         for the five science prizes: three external referees (two of whom must be based overseas);

·         an achievement summary of no more than 1 000 words;

·         a two-page curriculum vitae;

·         proof of Australian citizenship or permanent residency; and

·         for the early to mid-career awards: evidence that their research career spans no more than 10 years (or full time equivalent) from completion of their highest relevant tertiary qualification.

If a nomination is shortlisted, further material will be required in the final stage.

For eligibility, selection criteria, nomination guidelines and forms, visit: www.business.gov.au/scienceprizes or contact 13 28 46

For more examples of past recipients, visit: www.science.gov.au/pmscienceprizes

Chris Johnson

Health COAG meets

The Federal and State and Territory Health Ministers met in Melbourne recently at the Council of Australian Governments (COAG) Health Council to discuss a range of national health issues.

The meeting was chaired by the Victorian Health Minister Jill Hennessy and welcomed New Zealand Health Minister Dr Jonathan Coleman as a participant.

The Ministers considered a draft of the Health Practitioner Regulation National Law Amendment Bill 2017.

Once enacted, the Bill will make a number of important reforms to the operation of the National Registration and Accreditation Scheme and the powers of National Boards and the Australian Health Practitioner Regulation Agency. The Bill responds to recommendations arising from the Independent Review of the National Scheme undertaken in 2014–15.

All Health Ministers also endorsed a revitalised agenda to streamline the conduct of clinical trials in Australia. Clinical trials are an important driver in improving health outcomes through access to new drugs, devices and treatment.

Under this directive, all Governments have agreed to redesign trial operating systems around central coordinating units that will make it easier to conduct and participate in safe, high quality clinical trials. The Commonwealth has committed funding of $7 million over four years to support jurisdictional clinical trial reform.

The Ministers noted that timely negotiation of expiring National Partnership Agreements (NPA) was important for each jurisdictions’ planning and delivery of services. They agreed to continue a cooperative dialogue to progress discussions about a range of expiring funding arrangements to ensure current care and timely preventative services can continue to be delivered to the community.

Medical research at Commonwealth and State levels;  re-exposure prophylaxis for the prevention of HIV; meningococcal W; ear disease and hearing loss in Aboriginal and Torres Strait Islander children; digital health, childhood obesity, the implementation of the Health Care Homes program; end of life care; and the medicinal cannabis were all also discussed at the Health COAG.

In addition, the Ministers agreed that the Fifth National Mental Health Plan will re-emphasise its objective of suicide prevention and will therefore become the Fifth National Mental Health and Suicide Prevention Plan.

They also agreed to a national opt-out model for long-term participation arrangements in the My Health Record system.

Chris Johnson

German Chancellor presented Australian statement on global health

German Chancellor Dr Angela Merkel has received a position statement on global health from Australian scientists.

Australian Academy of Science President, Professor Andrew Holmes, and his colleagues from the S20 Science Forum presented the position statement late in March ahead of the G20 Summit in July.

“The Ebola and Zika epidemics have shown how disease in one country can have global impact. Infectious diseases are causing at least 15 per cent of cancer cases. And 15 per cent of tuberculosis cases may be linked to type II diabetes,” Professor Holmes said.

This issues illustrate why health will be an important focus at the G20 Summit, along with economic growth and financial market regulation.

The Science Academies of the G20 states have drawn up recommendations on improving global health and are playing an active role in the G20.

In their joint statement, the Academies offer strategies and tools to tackle communicable and non-communicable diseases and to strengthen public health systems. The joint document provides a basis for the G20 Summit consultations.

Professor Holmes was in Germany for the Science 20 Dialogue Forum where the statement was presented.

“Global health – specifically the management of both infectious and non-infectious diseases – still causes issues world-wide for individuals, health systems and economies alike,” he said.

“We are calling for strong short and long-term evidence-based strategies to address these issues.”

In the statement the G20 Academies of Sciences call for:

  • the strengthening of healthcare and public health systems;
  • applying existing and emerging knowledge;
  • addressing the broader social and environmental determinants of health; 
  • reducing serious risk factors for disease through education and promotion of healthy life styles;
  • ensuring access to health resources globally; and
  • enhancing and extending robust strategies for surveillance and information-sharing. 

Furthering research is a prerequisite for providing knowledge and new tools to meet these challenges.

You can read the full statement at: www.science.org.au/media

Chris Johnson

World first “brain training” could help smokers quit for good

Simple computer-based exercises which train smokers’ brains to improve their impulse control are being trialled at Deakin University’s School of Psychology.

It’s hoped the world-first Inhibitory Smoking Training (INST) program could help smokers give up for good.

Lead researcher, Associate Professor Petra Staiger, said tobacco remained the leading preventable cause of illness and death worldwide, killing approximately six million people every year.

“Despite the wide range of treatments designed to help people quit smoking, the vast majority relapse within six months,” Associate Professor Staiger said.

Deakin University cognitive neurosciences expert Dr Melissa Hayden, who is also on the INST team, says research suggests difficulties overcoming addiction may be partly due to an impaired ability to control automatic impulses.

“Recent advances in neuroscience have highlighted that one way to address this difficulty is by retraining people’s brains to improve their impulse control,” Dr Hayden said.

The INST trial is a collaboration with Dr Natalia Lawrence in the UK where the training technique has already enjoyed success helping people decrease the amount of unhealthy food they eat, leading to long-term (six months) weight loss.

The training has also helped people significantly reduce their alcohol consumption and Associate Professor Staiger said the method could have significant benefits over other quit programs.

“For a start, it’s cost effective. Australians have highlighted that the financial costs associated with smoking are the number one reason they want to quit,” she said.

“That means there’s a need for smoking treatments to not only be effective, but also cost-effective if they are going to facilitate quitting for good.

“If it works, this computer brain training task has the potential to reduce the global prevalence of smoking at no cost to the consumer.”

Associate Professor Staiger said the program was also time-efficient, taking only “10 to 15 minutes per day for two weeks”.

“Plus with brain training there are no negative side-effects. Quitting aids like patches or gum can sometimes have adverse side-effects which negatively impact their uptake and long-term adherence, but there are none of those issues here.” 

Researchers with the INST team are still looking for participants to take part in the world-first trial.

“We’re looking for smokers who wish to quit, aged between 18 and 60, living in the Melbourne metropolitan area and who smoke at least 10 cigarettes daily on average,” Associate Professor Staiger said.

“It’s a very simple program and you’ll only need access to a computer and internet for a two-week period.”

To find out more about the trial, contact the INST team at: inst@deakin.edu.au

Odette Visser

 

 

[Comment] Offline: The dark heart of the wood

“A family reunion that keeps us connected to the outside world.” So said Mamdouh Aker, a Trustee of Birzeit University, as he opened the annual scientific gathering of The Lancet Palestinian Health Alliance (LPHA), which last week returned in its eighth year to the home of its birth. Birzeit is one of the State of Palestine’s most prestigious global universities. The LPHA is a loose network of Palestinian, regional, and international researchers committed to the highest scientific standards in describing, analysing, and evaluating the health and health care of Palestinians—contributing to the global scientific literature and developing local evidence-based policy and practice.

[Review] The Lancet Countdown: tracking progress on health and climate change

The Lancet Countdown: tracking progress on health and climate change is an international, multidisciplinary research collaboration between academic institutions and practitioners across the world. It follows on from the work of the 2015 Lancet Commission, which concluded that the response to climate change could be “the greatest global health opportunity of the 21st century”. The Lancet Countdown aims to track the health impacts of climate hazards; health resilience and adaptation; health co-benefits of climate change mitigation; economics and finance; and political and broader engagement.