Australian suicide numbers climb at unacceptable rate
The Australian Bureau of Statistics has released its latest Causes of Death report, highlighting that Australians are taking their lives at an unacceptable rate. The number of Australians dying by suicide is higher than ever before, with figures showing 3128 people took their lives in 2017 compared with 2866 in 2016. SANE Australia CEO, Jack Heath, said that the increase in the overall suicide rate put the nation back to where it was 2 years ago – heading towards nine Australians taking their life every day. The major results of the report include: the suicide rate increased from 11.8 to 12.7 per 100 000 Australians; there was an average of 8.6 deaths by suicide in Australia each day; there were 2348 male deaths at a rate of 19.2 per 100 000; there were 780 female deaths at a rate of 6.3 per 100 000; suicide death rates are up in the ACT, Queensland, Western Australia, the NT and New South Wales; suicide death rates are down in Tasmania, with rates remaining the same in Victoria and South Australia. “We also know that the risk of suicide is higher for those living with complex mental illness and we still have a long way to go in reducing the stigma associated with complex mental illness and in facilitating access to adequate evidence-based care and support,” said Mr Heath. “We need to work more closely with people who have attempted suicide to better understand what we can do to assist people when they need it most – it is really important that we encourage people to seek help early on.”
Limiting kids’ screen time to 2 hours maximises learning
Limiting recreational screen time to less than 2 hours a day, and having sufficient sleep and physical activity is associated with improved cognition, compared with not meeting any recommendations, according to a study published in The Lancet Child and Adolescent Health. The Canadian 24-Hour Movement Guidelines for Children and Youth recommend at least 60 minutes physical activity per day, 2 hours or less recreational screen time per day, and 9–11 hours sleep per night in children aged 8–11 years. The Canadian study investigators obtained data from a cross-sectional observational study including 4524 US children aged 8–11 years from 20 study sites. Children and parents completed questionnaires and measures at the outset of the trial to estimate the child’s physical activity, sleep and screen time. Children also completed a cognition test, which assessed language abilities, episodic memory, executive function, attention, working memory and processing speed. The study controlled for household income, parental and child education, ethnicity, pubertal development, body mass index and whether the child had had a traumatic brain injury. Taken individually, limited screen time and improved sleep were associated with the strongest links to improved cognition, while physical activity may be more important for physical health. However, only one in 20 US children aged between 8–11 years met all three recommendations. The study found that US children spent an average of 3.6 hours a day engaged in recreational screen time. The researchers, say that their findings indicate that adhering to the guidelines during childhood and adolescence, particularly for screen time, is important for cognitive development. Meeting the physical activity recommendation alone showed no association with cognition. The authors note some limitations, including that their study is observational so cannot establish the underlying causes or the direction of the association. The data are also self-reported and could be subject to bias.
Contemporary contraceptive pills reduce ovarian cancer risk
Contemporary combined oral contraceptives (which tend to contain both lower doses of oestrogens and newer progestogens than older contraceptives) are associated with a reduced risk of ovarian cancer in young women, according to a large European study published by The BMJ. The results show that this positive effect strengthened with longer periods of use and persisted for several years after stopping, providing important reassurance for women, say the researchers, from the University of Aberdeen and the University of Copenhagen. Previous research has shown a reduced risk of ovarian cancer in women who take combined oral contraceptives, but most of the evidence relates to the use of older products, which tended to contain higher levels of oestrogen and older progestogens. Using national prescribing and cancer registers, the researchers analysed data for nearly 1.9 million Danish women aged 15–49 years between 1995 and 2014. Women were categorised as never users (no record of being dispensed hormonal contraception), current or recent users (up to 1 year after stopping use), or former users (more than 1 year after stopping use) of different hormonal contraceptives. Most of the hormonal contraceptive use (86%) related to combined oral products. After taking account of several factors, including age and parity, the researchers found that the number of cases of ovarian cancer were highest in women who had never used hormonal contraception (7.5 per 100 000 person years), whereas among women who had ever used hormonal contraception, the number of cases of ovarian cancer were 3.2 per 100 000 person years. There was no firm evidence to suggest any protective effect among women who used progestogen-only products, although the researchers point out that few women were exclusive users of these products. This limits the ability to detect an effect. The reduced risk for combined products was seen with nearly all types of ovarian cancer, and there was little evidence of important differences between products containing different types of progestogens. Similar results were also found among women followed up to their first switch in contraceptive type. Based on these figures, the researchers say that hormonal contraception prevented an estimated 21% of ovarian cancers in this group of women. This is an observational study, so no firm conclusions can be drawn about cause and effect, but they do support the findings of studies of older products.
Discovery may help improve ovarian cancer care
Researchers from the Walter and Eliza Hall Institute of Medical Research (WEHI) have revealed a better way to identify which patients should respond to powerful ovarian cancer drugs called PARP inhibitors (PARPi), resolving an important question in ovarian cancer care about why some patients respond to these drugs, while others do not. The findings add to a vital “checklist” that helps researchers to better match patients with ovarian cancer with the right therapy for their cancer. Being able to offer targeted treatment is crucial for patient survival rates that have seen little improvement over the past 30 years. The study, published in Nature Communications, was led by Professor Clare Scott, Dr Olga Kondrashova, Dr Matthew Wakefield and Dr Monique Topp from WEHI in collaboration with Associate Professor Alexander Dobrovic from the Olivia Newton-John Cancer Research Institute and LaTrobe University’s School of Medicine. “For the past two decades, it was thought that ovarian cancer patients whose cancer’s BRCA1 genes are ‘silenced’ – or methylated – have faulty DNA repair and therefore were good candidates for PARPi treatment,” said Professor Scott. “Yet, the puzzling thing was we were unable to predict the patients for which the drugs would work.” The researchers discovered subtle differences in some BRCA1 methylated cancers. These subtle yet significant epigenetic differences explained why some patients would respond to the drug, while others would not. Incomplete methylation isn’t enough to cause faulty DNA repair in cancer cells, which meant PARPi wasn’t going to be effective for those patients. Those in the group who had “complete” BRCA1 methylation in their cancer were responsive to PARPi, confirming that the treatment should not be discounted. Professor Scott said understanding the various reasons for PARPi resistance was an invaluable approach for developing better, more personalised patient care.
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