Led by Monash University and published in the Medical Journal of Australia, the recommendations address the unique challenges faced by some 39,000 people living with this chronic neurological condition.

Senior author Associate Professor Mastura Monif, a neurologist and researcher from the Monash University School of Translational Medicine and head of Alfred Health’s Neuroimmunology Service, said although Australia’s Therapeutic Goods Administration (TGA) adopted an international MS guideline in 2009 (which was last updated in 2015), specific and recent consensus recommendations were needed to guide best practice on locally available therapies and local practices.

“New disease-modifying therapies are more effective and better tolerated,” says Associate Professor Monif.

“But it’s a much more complex treatment landscape than it was 20 years ago, and there is new evidence being generated all the time on many aspects of the disease.

“It is really important that the approach used is focused on both the effectiveness and safety for the individual so they can get the best possible outcome.”

Developed by more than 30 experts from the Australian and New Zealand Association of Neurologists working group — including MS specialists, nurses, allied health professionals, and patient advocacy groups — the statement covers pre-assessment, therapy selection, monitoring, symptom management, and special considerations such as pregnancy and infections.

MS Australia CEO Rohan Greenland welcomes the guidelines as an “invaluable resource, especially for generalist clinicians navigating this rapidly evolving field”.

“They provide a clear and ready reference to best-practice evidence and expert consensus – an important milestone in MS care in Australia,” he says.

First author Dr Jessica Shipley, an MS and Neuroimmunology fellow at Alfred Health, says the recommendations are for everyone involved in managing MS, regardless of healthcare setting or location.

“These recommendations will be a valuable resource for everyone from GPs,  to neurologists, doctors in training, medical students, allied health professionals, nursing staff, and consumers or patients,” says Dr Shipley.

The recommendations can be found here:

• Part 1: Consensus recommendations on MS management in Australia and New Zealand.
• Part 2: Consensus recommendations ons MS management in Australia and New Zealand.

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New Zealand researchers have discovered that sarmentosin, a novel bioactive compound found in blackcurrant powder and juice, acts as a Monoamine oxidase-B (MAO-B) inhibitor — a function that helps preserve dopamine levels in the brain, which are vital for mood regulation and cognitive health.

The study, published in The Journal of Agricultural Chemistry, was conducted by researchers from Plant & Food Research and Callaghan Innovation, and revealed that sarmentosin directly inhibits MAO-B enzymes, providing a natural alternative to synthetic inhibitors, which are said to be often associated with adverse side effects.

“While previous studies suggested that MAO-B inhibition was linked to bioactives other than anthocyanins in blackcurrants, it wasn’t until this study that we identified sarmentosin as the primary bioactive behind this function,” Dr Dominic Lomiwes, Science Team Leader for Immune Health & Physical Performance at Plant & Food Research, said.

As part of the randomised, placebo-controlled, crossover clinical study blood samples from healthy individuals were analysed to further examine the effect of sarmentosin on MAO-B activity.

Blood sample analysis results showed further the potent effects of sarmentosin on MAO-B — sarmentosin significantly reduces MAO-B activity, supporting the maintenance of dopamine levels and, in turn, mood and cognitive performance.

“We observed MAO-B inhibition in every participant who consumed the blackcurrant products containing sarmentosin. What’s remarkable is that the effect we saw in the lab translated directly to human subjects, which is extremely exciting,” Dr Lomiwes said.

‘Mind-blowing commercial possibilities’

This groundbreaking discovery has already sparked commercial innovation.

New Zealand-based functional food company Ārepa — the study’s partner — has patented the new molecule sarmentosin for use in its brain health products, which are available through Coles and Woolworths.

Ārepa co-founder Angus Brown says the potential application of this discovery for the functional food and beverage industry is very exciting.

“The commercial possibilities of the discovery of sarmentosin and its positive effects on brain health are pretty mind-blowing,” Mr Brown said.

“We can now extract the sarmentosin molecule from our Neuroberry blackcurrants and use it in other food and beverage products, and know it will have the same effect.”

Plant & Food Research Chief Scientist Professor Richard Newcomb highlights the importance of this discovery for both the scientific and commercial sectors in New Zealand.

“The results from this clinical trial are incredibly encouraging and lay the foundation for new innovations that benefit both consumers and businesses,” he said.

What the study means for Australians 

The discovery is of global importance and suggests a natural alternative that could be used to support mood, mental health and overall cognitive function.

It could play a key role in the prevention of age-related mental decline, supporting healthy ageing and longevity.

This is particularly important given Australia’s ageing population – which is expected to nearly double to 8.8 million by 2057 – and Dementia is set to become the leading cause of death in the country.

Melbourne-based Professor of Human Psychopharmacology and Chief Scientific Officer at Ārepa, Professor Andrew Scholey, expects to see new innovations in food and medicine arise over the years to improve mental health and help promote healthy brain function.

His goal is to find natural-based solutions to delay the onset of neurological decline through science-backed brain foods that can be scaled and made accessible and convenient for everyone worldwide.

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National President of the Pharmacy Guild of Australia, Professor Trent Twomey, said the current GP shortage meant patient wait times were endangering those with Covid-19.

“This is backed by recently revealed Healthengine data. For example, in 2019 the average wait time in Victoria was 1.98 days and now it’s 3.33 days. WA and NSW are the worst-performing States, where a patient has to wait an average of 4 and 4.17 days respectively to see a GP,” Professor Twomey said.

“These wait times are unacceptable. Given the treatment program of these life-saving anti-viral medicines needs to commence within five days of the initial onset of Covid-19 symptoms, it’s vital that patients test early and often and receive treatment without long delays due to the lack of GP appointments.”

Professor Twomey said New Zealand had recently followed the example of Canada and the United Kingdom and made the Covid-19 anti-viral medicines available at local community pharmacies across the country to ensure its citizens received timely access to these life-saving medicines.

“Australian patients deserve the same access to the Covid-19 antivirals,” he said.

“Community pharmacists in Australia have the skills, expertise and knowledge to assist patients so there is no reason for delaying treatment to eligible patients.

“As highly trained medicine experts, pharmacists understand drug interactions, can adjust dosing as required and refer more complex patients to a medical practitioner to ensure better triaging across limited GP appointments.

“If Australia followed the New Zealand example, we could greatly reduce Covid-19 hospitalisations, increase the number of patients receiving treatment in a timely manner, increase productivity and save hundreds of millions of dollars in hospital expenditure by empowering community pharmacy.

“Community pharmacists continue to demonstrate their important role in primary care with the delivery of over 8 million doses of Covid-19 vaccinations nationally and the recent positive results from the Urinary Tract Infection prescribing pilot in Queensland being a testimony to the robustness of pharmacists’ skills and competencies in this country.”

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Featuring premium-grade ingredients, the PRO Series range includes 18 new products designed to support overall health and wellbeing.

According to GO Healthy Australia General Manager Alex McDonald, GO Healthy’s PRO Series was formulated with two things in mind: supporting wellness through premium ingredient combinations, and convenience.

“As GO Healthy continues to go from strength to strength in Australia, the PRO Series was designed to complement our existing range by providing consumers with access to naturopathic formulations that are easily available over the counter,” he said.

“The PRO Series will sit alongside our regular GO Healthy range and will launch with products across four categories; Sleep and Nervous Health; Joint and Bone; Immunity and General Health.”

GO Healthy PRO Series is available nationally.

Some products from the range include:

• PRO Ashwagandha Sleep (60 Capsules, RRP $49.99). Formulated with ingredients traditionally used in Western Herbal medicine to relieve sleeplessness, assist mind relaxation and to support the nervous system (sleephealthfoundation.org.au).
• PRO Immune Support (60 Capsules, RRP $34.99 / 120 Capsules, RRP $59.99). Specially formulated with Andrographis (2500mg), which decreases the severity of common cold and mild respiratory tract infection symptoms. GO Healthy’s PRO Immune Support also contains a high dose of Echinacea, which is traditionally used in Western Herbal Medicine to relieve symptoms of mild upper respiratory tract infections, and the common cold.
• PRO Saffron Mood (60 Capsules, RRP $59.99). As one of the “highest concentrations” of saffron supplements on the market, GO Healthy’s PRO Saffron Mood helps to support a healthy mood balance and relieve symptoms of mild anxiety.
• PRO Adrenal Support (30 Capsules, RRP $29.99). Specially formulated with carefully selected herbs and vitamins including Siberian Ginseng for maintaining physical endurance and stamina and Panax Ginseng for maintaining cognitive function and reducing mental fatigue.
• PRO Curcumin Active (30 Capsules, RRP $44.99). A premium quality formula that contains a high dose of patented curcumin extract (the active compound in Turmeric) that is more easily absorbed by the body. Containing five times more curcumin per capsule than other brands, PRO Curcumin Active uses a delivery system that has the highest absorption rate on the market.

For more information on GO Healthy’s PRO range or to find a stockist, visit gohealthy.com.au. GO Healthy PRO Series is available nationally.

Always read the label and follow the directions for use. If symptoms persist, talk to your health professional. Vitamin and mineral supplements should not replace a balanced diet.

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Set to provide a strong foundation for innovation and increase energy efficiency, the new solutions will be delivered through HPE’s high-performing and versatile ProLiant servers.

Chemist Warehouse serves more than 1.5 million customers each week, whether in-store, online, or through third party providers such as Alibaba’s Tmall marketplace. The pharmacy giant has a growing footprint in New Zealand, China and Ireland.

As a result of its rapid growth, Chemist Warehouse aims to transform its data centre, completely overhauling its existing IT Infrastructure, to improve operations for better sales and customer experiences, and adapt to recent shifts to remote working experiences. By collaborating with HPE to design a bespoke VDI solution using HPE ProLiant servers, Chemist Warehouse gains foundational support to implement future solutions to enhance automation and sustainability efforts.

“Our commitment to modernising our IT is critical for us to achieve our transformation goals and continued growth. With reduced administrative overheads, we can reallocate resources to innovation,” says Simon Hibbert, General Manager of IT at Chemist Warehouse.

“The initial beneficiaries will be our staff, which will experience improved productivity and in return, will have a positive, downstream impact to our customers in-store and online.”

HPE is helping Chemist Warehouse transform its IT with an infrastructure environment delivered through HPE ProLiant DL325 Gen10 Plus servers using 2nd Gen AMD EPYC processors that take advantage of the latest VMware vSAN all-flash capabilities for a software-defined experience. The upgraded data centre will also increase energy efficiency by consuming 30% less power than its existing solution, helping to advance Chemist Warehouse’s sustainability goals.

“We look forward to accelerating our collaboration with Chemist Warehouse to increase efficiency and build a foundation for future growth,” says Andrew Foot, general manager of Compute for HPE South Pacific. “The new environment, enabled by HPE ProLiant servers, will deliver better performance, energy efficiency, user experience and lower latency.”

The current solution is for core systems for the Chemist Warehouse Australia operation.

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Released today, the Australian Institute of Health and Welfare (AIHW) report looks into the health effects of Covid-19 on Australians from 2020 to early 2021, including data from a range of sources covering 2020 up to June 2021. However, it does not include data from the latest wave of cases that began in June 2021, dominated by infections of the Delta variant.

“As the Covid-19 situation continues to evolve rapidly and we face challenges such as the emergence of new variants of the virus, it is important we look holistically at the direct and indirect health effects of the pandemic on Australians,’ says AIHW spokesperson Dr Lynelle Moon.

As at 20 June 2021 there had been over 30,000 confirmed cases of Covid-19 and 910 deaths from the disease.

International comparisons

During the first year of the pandemic, Australia avoided the level of health impacts seen in many other countries, where there were large numbers of severe cases and deaths.

“We closely compared Covid-19 case and death rates in Australia with four other countries that have similar proportions of people over 65; similar life expectancy at birth; and similar health systems and expenditure on health care,” says Dr Moon.

“If Australia had experienced the same crude case and death rates as Canada, Sweden or the United Kingdom, by early April 2021 there would have been between 680,000 and 2 million cases instead of the 29,000 that did occur, and between 16,000 and 48,000 deaths.

“Conversely, if Australia had the same crude case and death rates as New Zealand, there would have been around 18,000 fewer cases and 780 fewer deaths,” says Dr Moon.

Years of healthy life lost

The report uses burden of disease analysis to look at the number of healthy years of life Australians who contracted Covid-19 may have lost.

“There were just over 8,400 disability-adjusted life years (DALYs) lost in 2020 from Covid-19 in Australia and 97% of this disease burden was from fatal cases,” says Dr Moon.

“This is much lower than the burden due to leading diseases in Australia. By comparison, coronary heart disease (CHD) was responsible for around 312,000 DALYs and respiratory infections for 80,500 DALYs in 2018.  Covid-19 would rank about 135th out of 219 diseases in terms of total burden of disease,” says Dr Moon.

Similar analysis from Scotland also included comprehensive burden of disease estimates for Covid-19 in 2020. The analysis suggests Covid-19 would be the second leading cause of disease burden in Scotland, behind coronary heart disease.

Population groups

Certain groups in the Australian population experienced higher rates of severe disease and death from Covid-19 during 2020.

During 2020, 7% of all Covid-19 cases in Australia and 75% of all deaths were in people living in residential aged care facilities. Up to early July 2020, it is estimated that health care workers in Australia were 2.7 times as likely to contract Covid-19 as the general community.

“People living in the lowest socioeconomic areas had Covid-19 mortality rates 2.6 times higher than for people living in the highest socioeconomic areas,” says Dr Moon.

“The reason for these inequalities are complex, and interpreting this finding is complicated by the majority of deaths being in residential aged care facilities. However, these socioeconomic differences do not appear to be driven by aged care facilities being over-represented in lower socioeconomic areas,” says Dr Moon.

Mental health

The initial impacts of the pandemic in Australia appeared to have increased levels of psychological distress, particularly for adults aged 18–45.

“By April 2021, the average level of psychological distress had returned to pre-pandemic levels, however continued to be higher for young people,” says Dr Moon.

Health behaviours

Between April and June 2020 (during which time lockdowns and other restrictions were in force in many parts of the country), Australians Bureau of Statistics Survey data shows some Australians increased their physical activity, including exercise. However, a similar number of people decreased their physical activity.

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The Global Cardiovascular Research Funders Forum has been founded by 11 leading research funders from across Europe, the United States, Canada, Australia, and New Zealand.

The founding members are:

• The American Heart Association;
• The British Heart Foundation;
• The Danish Heart Foundation;
• The Dutch Heart Foundation;
• The German Centre for Cardiovascular Research;
• The Leducq Foundation;
• The Heart and Stroke Foundation of Canada;
• The Institute of Circulatory and Respiratory Health, Canadian Institutes of Health Research, Canada;
• The National Heart Foundation of Australia;
• The National Heart Foundation of New Zealand;
• The Swedish Heart Lung Foundation.

The new Forum aims to accelerate the pace of progress by creating opportunities for cross-border coordination and collaboration between world-leading cardiovascular researchers and organisations.

The Forum’s collective mission is to “advance global cardiovascular health by catalysing, supporting and promoting transformational international research efforts in heart, stroke and circulatory diseases”.

The Forum will initially collaborate by sharing information on research funding priorities, strategic initiatives, and clinical trials.

“Despite the astonishing progress that research has made in recent decades, heart disease remains the world’s biggest killer. Today 35 people will die every minute from a heart and circulatory disease,” says Dr Charmaine Griffiths, Chair of the Global Cardiovascular Research Funders Forum and Chief Executive of the British Heart Foundation

“Putting an end to the suffering caused by these diseases requires an immense international effort.

“By coming together as the world’s leading funders in cardiovascular science, we can coordinate our research efforts and set a clear international agenda for cardiovascular science.”

Heart Foundation Group CEO, Adjunct Professor John Kelly, says the partnership would connect the best cardiovascular expertise from around the world.

“It brings together some of the biggest non-government funders of heart research in the world,” says Adjunct Professor Kelly.

“Individually, we have funded research that has led to many breakthroughs in the prevention and treatment of heart disease.

“Researchers often need to work with very large amounts of data. This partnership will provide the scale that is needed to deliver reliable evidence.

“It will help researchers and organisations in different countries collaborate more effectively and plan ambitious, practice-changing clinical trials.

“It has the potential to improve the lives of half a billion people currently living with cardiovascular disease worldwide, and to save millions of lives in the future.”

The Heart Foundation is accepting expressions of interest from Australian clinical researchers who are seeking support to conduct multinational cardiovascular trials.

The Heart Foundation is part of a sub-group that will coordinate proposals from researchers.

Australian clinical researchers interested in establishing new multinational clinical trials are invited to submit an expression of interest.

Details can be found on the heart foundation website: heartfoundation.org.au/conditions/global-cardiovascular-research-funders-forum

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A new analysis from C-suite strategy firm Provocate, reveals Australia’s Covid-19 vaccination rollout fell down the international rankings in May after slipping further behind national targets at home.

The findings from the May issue of Provocate’s independent VacEnomic Forecaster report reveals that Australia fell five places in the past month from fifth to 10^th of 14 nations benchmarked by the Australian Department of Health, overtaken by Germany, France, Italy, Belgium and the European Union at the same point in their own vaccination rollouts.

Reportedly, lower-ranked countries, such as New Zealand, South Korea, Canada and Japan, also grew at about double the pace of Australia in their third month of the vaccine rollout (table 1).

According to Provocate Managing Director, Troy Bilsborough, while the latest Victorian lockdown has seen a welcome lift in vaccination rates in the past week, this is still half the 20,000 daily vaccinations needed to meet the Federal Budget’s revised target of completing the rollout by the end of 2021 (table 2).

“Australia’s lagging rate of vaccination at home is having a significant impact on its global standing, as well as the risk of market share losses to competitor countries that reopen faster,” says Mr Bilsborough.

“For example, Australia has one of the slowest start dates and lowest vaccination rates of all G20 nations.

“The current ‘grass is greener’ message around an end of year vaccination boost is the single biggest risk to Australia’s vaccine rollout right now and will only increase as Federal Election pressure mounts.

“We remain concerned that the daily boost in Covid-19 immunisations driven by Victorian lockdown fear will only be temporary unless governments can harness this lapse in vaccine hesitance to their advantage.”

Mr Bilsborough says that unless Australia is “consistently averaging at least one million jabs per week, every week, then business should plan for a vaccine rollout competition closer to 2023 than 2021”.

He adds that inconsistency is one of the biggest reasons for Provocate’s position, with recent records of 100,000 vaccinations in a day reportedly being undercut by days as low as 10,000 or less last month.

Reportedly, Provocate’s VacEnomic Forecaster shows that there’s about 13 million additional vaccinations required for Australia to reach the top rate of herd immunity (48m; 95%) and the lower end of Covid-19 (35m; 70%).

Table 1: Change in Australia’s global standing on vaccination rates based on Australian Department of Health’s ‘International Comparisons at equivalent stages of rollout

Source: Provocate analysis of Australian Department of Health ‘International Comparisons at equivalent stages of rollout’ data as at 22 April 2021 (click here, p4) vs data as at 22 May 2021 (click here, p4)

Table 2: Increase in number of daily vaccinations needed from now onwards to meet Australian Government targets due to slower-than-expected growth in daily vaccination rates.

Source: Provocate analysis of vaccination statistics from Australian Department of Health & Our World in Data.

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While research has discovered that AAAs are less common in patients with diabetes, researchers are now investigating whether Metformin, a widely accepted treatment for T2DM due to its anti-inflammatory effects, has an effect on AAA growth and rupture.

“Currently, once an AAA is detected, we have to monitor the aneurysm until it expands to a size where surgery can be performed. Our hope for the trial is to establish if Metformin can not only prevent the need for surgery, but prevent any further growth and rupture,” says Associate Professor Anthony Dear from Monash Eastern Health Clinical School, who is leading the Metformin Aneurysm Trial (MAT) in Melbourne.

AAAs are difficult to detect, but some people notice constant pain in their abdomen, back pain and a pulse near their belly button.

There are a number of factors that play a role in developing an AAA, with the condition more prevalent in men, smokers, those with family history, people over 65 or those who have experienced an aneurysm in another large blood vessel.

The multi-centre randomised placebo-controlled trial is taking place across Australia, New Zealand, Sweden and the UK and is being supported by The George Institute for Global Health, National Health and Medical Research Council Australia (NHMRC) and James Cook University, Australia.

To learn more about the study, visit: georgeinstitute.org/projects/mat-study-determining-the-effects-of-metformin-among-people-with-small-abdominal-aortic

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In response to this, a network of specialists from the Murdoch Children’s Research Institute (MCRI) have recently created Australia and New Zealand’s first set of clinical guidelines for childhood head injuries.

Published in Emergency Medicine Australasia, the guidelines will enable emergency department clinicians to best diagnose and treat children’s head injuries, while also reducing unnecessary exposure to radiation from CT scans.

They also address head injuries in children with underlying problems, such as bleeding disorders.

“While we need to rule out any bleeding in the brain, we don’t want to order CT scans unnecessarily, because it increases children’s lifetime radiation exposure,” says Professor Franz Babl, MCRI Group Leader of Emergency Research.

The guidelines were developed by the Paediatric Research in Emergency Departments International Collaborative (PREDICT) following an extensive search and assessment of international guidelines such as those used in Canada, the US and the UK.

The PREDICT working group developed 71 recommendations and an imagining/observation algorithm relevant to the Australian and New Zealand setting.

The new guidelines cover patient triage, imaging, observation versus admission, transfer, discharge and follow up, and can be view at: predict.org.au/

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