GPs centre of government’s new chronic illness care plan
The federal government has pledged to overhaul chronic disease care in what it describes as one of the biggest health system reforms since the introduction of Medicare 30 years ago. The Healthier Medicare plan, unveiled last week, promises a trial of “health care homes” in 200 general practices, according to Medical Observer. One in five Australians live with two or more chronic conditions, and a third of Indigenous Australians report living with three or more long term conditions. There will be an initial trial for about 65 000 patients at 200 medical practices, which will feature tailored care packages, new health care homes with nominated GP practices and an improved use of digital health measures to lift efficiencies. The Australian Medical Association has welcomed the announcement of health care homes, particularly the pivotal role of general practice in primary health care in Australia. “GPs in Australia, working with other specialists and other health professionals, are already delivering high quality and well coordinated care for patients,”, AMA President Professor Brian Owler said. “The proposed health care home has the potential to build on this established practice – provided we get the new model right.” For more, visit doctorportal.

One-fifth of world’s adults obese by 2025
In the past 40 years, there has been a startling increase in the number of obese people worldwide — rising from 105 million in 1975 to 641 million in 2014, according to the most comprehensive analysis of trends in body mass index (BMI) to date, published in The Lancet. The age-corrected proportion of obese men has more than tripled (3.2% to 10.8%), and the proportion of obese women has more than doubled (6.4% to 14.9%) since 1975. At the same time, the proportion of underweight people fell more modestly — by around a third in both men (13.8% to 8.8%) and women (14.6% to 9.7%). Over the past 4 decades, the average age-corrected BMI increased from 21.7 kg/m² to 24.2 kg/m² in men and from 22.1 kg/m² to 24.4 kg/m² in women, equivalent to the world’s population becoming on average 1.5 kg heavier each decade. If the rate of obesity continues at this pace, by 2025 roughly a fifth of men (18%) and women (21%) worldwide will be obese, and more than 6% of men and 9% of women will be severely obese (BMI of 35 kg/m² or greater). Almost a fifth of the world’s obese adults (118 million) live in just six high-income, English-speaking countries — Australia, Canada, Ireland, New Zealand, UK, and USA. Over a quarter (27.1%; 50 million) of the world’s severely obese people also live in these countries.

Type 1 diabetes linked to threefold risk of epilepsy
People with type 1 diabetes mellitus (T1D) have a threefold increased risk of developing epilepsy later in life, according to research published in Diabetologia. T1D is one of the most common autoimmune disorders in children, with a 3% annual increase in the global incidence rate since the 1980s. In recent decades, the incidence of T1D has increased in children and adolescents, particularly those aged younger than 5 years. Recent studies have found that T1D could be a risk factor for the development of epilepsy in children, although the exact underlying mechanisms remain unknown. In this new study, Dr I-Ching Chou, from China Medical University Children’s Hospital, Taichung, Taiwan, and colleagues evaluated the relationship between T1D and epilepsy in Taiwan using data from the Taiwan National Health Insurance Research Database. The study cohort contained 2568 patients with T1D, each of whom was frequency-matched by sex, urbanisation of residence area and index year with 10 control patients without T1D. In patients with T1D, the risk of developing epilepsy was significantly higher than that in patients without T1D. After adjusting for potential confounders, the T1D cohort was 2.84 times more likely to develop epilepsy than the control cohort.

Big data to help see small cells
Researchers have successfully combined computer analysis with microscopy, to extract highly detailed cellular information that will help distinguish between healthy and diseased cells in areas as diverse as cancer, injury and inflammation. The approach, reported in the journal Scientific Reports, has shown that subtle biochemical signatures of cells can be captured and then categorised to an extent that has never been seen before. Co-author on the journal article, Ewa Goldys, Deputy Director of the Centre for Nanoscale BioPhotonics (CNBP) and a professor at Macquarie University, said: “We’ve already been able to successfully detect genetic mutations in cancer cells and bio-markers related to diabetes, as well as to non-invasively distinguish stem cells from other cells in the body. Key to our approach has been the development of a highly bespoke piece of software and building on 21st century computing capability. It has allowed us to quantitatively characterise the cell populations being viewed under the microscope, and to then identify colours and patterns related to specific conditions. The use of big data in biology is a rapidly evolving field with a great potential to impact positively on many lives. It’s an exciting time to be a researcher. Big data is having a big biological impact.”

No decision on ADHA board or CEO
The new Australian Digital Health Agency (ADHA) is still without a chief executive and board just 3 months out from its official starting date of 1 July, according to a report in Pulse+IT. Labor has demanded that the government consult with it on senior economic positions but this is not thought to include the establishment of the ADHA, which will take over responsibility for the My Health Record and the role of the National E-Health Transition Authority, which will be dissolved. In other news from Pulse+IT, Australia’s leading general practice software vendor MedicalDirector has been sold by owner Primary Health Care to a private equity firm for $155 million. MedicalDirector has reported healthy revenues of over $30 million annually for the past couple of years. In Primary Health Care’s most recent financial results, it reported revenues of $21 million for the first half of the 2016 financial year, up by 12.3 per cent on the previous period, for earnings before tax of $6.8 million. The sale is expected to complete before the end of the financial year.

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