NeuRA Magazine #26

New report

NEW REPORT REVEALS OSTEOPOROSIS CARE GAP

Professor Jacqueline Close, Geriatrician and Co-Chair of the Australian and New Zealand Hip Fracture Registry (ANZHFR) based at NeuRA with Orthopaedic surgeon Professor Ian Harris, recently released findings from the 2018 Hip fracture Registry that showed Australia is still significantly behind other countries in closing the osteoporosis care gap.

Data from the report produced by the Australian and New Zealand Hip Fracture Registry, based at NeuRA, shows only 25 per cent of hip fracture patients leave hospital on active treatment for osteoporosis and only 24 per cent of hospitals provide individualised written information on prevention of future falls and fractures.

“There are huge opportunities to further improve hip fracture care including the prevention of future falls and fractures. Strong evidence exists to support treatment of osteoporosis in this population yet all too frequently we fail to offer treatments which can impact on people’s lives,” said Professor Close.

Professor Harris said hospitals are now sharing their waiting times from arrival to surgery, helping to generate a more transparent snapshot of performance against a national standard.

“Currently the most common delay for people waiting more than 48 hours for surgery is access to operating theatre time. This is something we must address,” said Professor Harris.

Professor Harris, Orthopaedic Surgeon and Co-Chair of the ANZHFR, said data is a powerful driver of change in the health system. “The Registry is run by clinicians for clinicians and provides hospitals with real-time performance data, allowing them to see how they perform against other hospitals.”

Although the incidence of minimal trauma hip fracture has decreased over time, the actual number of hip fractures continues to increase due to the rising number of older adults. Current projections suggest that by 2022 there will be more than 30,000 hip fractures each year with a projected cost of $1.126 billion. Minimal trauma fractures are relatively common in people aged 50 and over.

It is estimated that, for Australians in this age group, one in four men and two in five women will experience a minimal trauma fracture. A hip fracture is one of the most serious types of minimal trauma fracture. In 2015-16, approximately 22,000 people aged 50 and over were hospitalised for a minimal trauma hip fracture with the need for hospitalisation highest for those aged over 85.

Women were one and a half times more likely than men to be admitted to hospital with a hip fracture.

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Exploring the electrophysiology and heritability of wellbeing and resilience

The majority of adults without a mental illness still experience poor mental health, indicating a need for a better understanding of what separates mental wellness from mental illness. One way of exploring what separates those with good mental health from those with poor mental health is to use electroencephalography (EEG) to explore differences in brain activity within the healthy population. Previous research has shown that EEG measures differ between clinical groups and healthy participants, suggesting that these measures are useful indicators of mental functioning. Miranda Chilver’s current project aims to examine how different EEG measures relate to each other and to test if they can be used to predict mental wellbeing. Furthermore, she hopes to distinguish between EEG markers of symptoms including depression and anxiety, and markers of positive symptoms of wellbeing to better understand how wellbeing can exist independently of mental illness. This will be done by obtaining measures of wellbeing and depression and anxiety symptoms using the COMPAS-W and DASS-42 questionnaires, respectively. Because EEG measures and mental wellbeing are both impacted by genetics as well as the environment, Miranda will also be testing whether the links found between EEG activity and Wellbeing are driven primarily by heritable or by environmental factors. This information will inform the development of future interventions that will aim to improve wellbeing in the general population. To achieve these goals, the project will assess the relationship between EEG activity and wellbeing, and between EEG and depression and anxiety symptoms to first test whether there is an association between EEG and mental health. Second, the heritability of the EEG, wellbeing, depression, and anxiety will be assessed to determine the extent to which these variables are explained through heritable or environmental factors. Finally, a model assessing the overlap between the heritable versus environmental contributions to each measure will be developed to assess whether genetics or environment drive the relationship between EEG and mental health. This project is based on a sample of over 400 healthy adult twins from the Australian TWIN-E study of resilience led by Dr Justine Gatt. This research will pave the way for improved mental health interventions based on individual needs.
PROJECT