The latest projects are investigating novel approaches to treatments for high-grade serous ovarian carcinoma, the most common type of ovarian cancer. They could produce life-saving results for women whose current five-year survival rate is just 48%.

Treatment options are limited, and patients often respond poorly to therapies that can have severe side effects. The recurrence rate is about 80% and treatment often fails.

Melbourne nurse Annabel Dance, who was diagnosed with ovarian cancer in 2019 and continues to undergo treatment, says given the lack of advanced in ovarian cancer treatment in recent decades any new developments were welcome.

“Any sort of advances in treatment will hopefully improve the survival rate,” she says. “These new projects funded by the Ovarian Cancer Research Foundation could make a big difference for many women.”

Professor Ron Firestein, Head of the Cancer Centre at the Hudson Institute of Medical Research, will lead a project investigating ways to disrupt the workings of a protein called the PAX8 (Paired-Box Gene 8). It increases the ability of cancer cells to grow and metastasise, so understanding how it works could lay the groundwork for improved treatments.

Professor Matthias Ernst from the Olivia Newton-John Cancer Research Institute, La Trobe University’s School of Cancer Medicine, will investigate a new approach to improving patients’ response to treatment. His team wants to know if reducing the level of the Hematopoietic Cell Kinase (HCK) protein in ovarian cancer patients can improve their response to a new combination of therapies.

OCRF CEO Lucinda Nolan says research was crucial as treatment options had not significantly improved in 30 years. Progress was needed across prevention, early detection, and treatment.

“Women and girls, here and now, deserve more options, which is why the OCRF is thrilled to be funding such promising projects that could change the treatment landscape for ovarian cancer,” says Ms Nolan.

“Ovarian cancer kills one woman in Australia every eight hours. A lack of focus on personalised treatment means many women and girls suffer needlessly.”

Professor Firestein says he was indebted to the OCRF for funding this ‘blue sky’ project, which should generate enough data to attract government funding for further research.

“We believe there is huge potential to identify and validate new therapeutic targets for ovarian cancer using this approach,” he says. “Time will tell, but the strength of this approach is that we are screening all genes for targets, so there is a much higher likelihood of finding the ‘needle in the haystack’ that may translate into an effective therapy.”

Professor Ernst says it was the first time that HCK had been pursued as a therapeutic target in high-grade serous ovarian cancer. Based on his team’s experience with colon, stomach, pancreas and breast cancer tumours, he was confident of identifying benefits in pursuing HCK.

“Our team is world leading when it comes to researching the role(s) for HCK in solid malignancies,” he says. “We hope, of course, that drugs that can inhibit HCK will eventually reach into the clinic and have impact.”

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Findings from the trial are expected to provide important data on the potential merits of vaccinating people with fractional booster doses of Covid-19 vaccine—as opposed to a full booster dose —which could guide future Covid-19 vaccination strategies. For example, results could suggest that a reduced booster dose would improve, broaden, and prolong the immune response following a primary series of Covid-19 vaccination, while also putting less strain on first dose supplies.

The trial data could also offer crucial information as to whether fractional doses of Covid-19 vaccines produce fewer side effects in vaccine recipients following administration (compared to a full dose), which could improve the acceptability of booster doses. Additional data on administering heterologous (‘mix-and-match’) Covid-19 vaccine schedules will also be generated.

Up to 3300 healthy adults will be invited to take part in the trial across Australia, Indonesia, and Mongolia. Depending on the trial location, participants will already have received their primary vaccination course (two doses) of either Pfizer, Oxford/AstraZeneca, Sinovac or Sinopharm Covid-19 vaccines. Participants will then receive either a full or reduced dose of one of three booster shots – Pfizer/BioNTech, Moderna or Oxford/AstraZeneca (in Indonesia). All three booster vaccines being trialled have received Emergency Use Listing (EUL) by the World Health Organization (WHO) and hold commitments to supply doses to COVAX.

Launch of the CEPI-MCRI research programme follows a recent statement made by the WHO urging broader global access to Covid-19 vaccines for both primary vaccinations and booster doses to maintain Covid-19 immunity in light of the emergence and impact of new variants like Omicron. While the rollout of booster doses continues to accelerate in many high-income countries, populations in many low-income nations are still waiting for their first Covid-19 vaccine dose, resulting in a serious imbalance in global protection.

“Over 10.4 billion doses of safe and effective Covid-19 vaccines have now been delivered worldwide, and the rollout of booster doses has dramatically ramped up in response to the cataclysmic spread of the highly infectious Omicron variant. However, despite this major progress, we continue to see a terrible chasm between rich and poor nations, with the vast majority of populations in low-income countries still waiting for their first dose, says Melanie Saville, Director of Vaccine Research & Development at CEPI.

“To prevent the further spread of this unforgiving virus and its troublesome variants, we need to achieve vaccine equity, fast. This new partnership will be key to showing us whether reduced booster dose shots could provide adequate protection against current and future variants, while also potentially showing that supplies of first doses to those in urgent need not be compromised,” says Dr Saville.

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The report, `Unleashing the potential: an open and equitable health system,’ presents expert advice to the Queensland Government on “how best to harness the opportunities arising from the Covid-19 pandemic response to support the best possible health and healthcare for Queenslanders.”

The Pharmacy Guild of Australia, Queensland Branch President, Chris Owen, welcomes the report’s release and says community pharmacists are ready and willing to take part in seeing the recommendations put into action.

“One of the lessons out of the Covid-19 pandemic was that communities wanted to be able to seamlessly engage with multiple primary healthcare providers to receive the best care possible,” says Mr Owen.

“Community pharmacies are a critical part of primary healthcare with consumers visiting, on average, 18 times a year.” “In Queensland alone, we have seen almost 1.2 million Covid-19 vaccinations administered in community pharmacies since June 2021. Access to vaccines in the local community was crucial to achieving the high vaccination rate we’ve been able to achieve,” Mr Owen says.

Mr Owen also said enacting the report’s key recommendations, including “expanding pharmacist-administered vaccinations and prescribing” (Pg. 127, Final Report), would go a long way of alleviating the pressure on Queensland’s emergency departments.

“We’ve all heard the stories of the long queues and pressure on our hospitals,” says Mr Owen, “many of the non-urgent presentations to emergency departments include supply of repeat prescriptions, vaccinations and common ailments like acne, sunburn and muscle cramps – all of which could easily be dealt with at a local community pharmacy.”

“This report goes a step beyond this by calling for an expansion of vaccinations and the ability to prescribe some medications within community pharmacy. These findings are welcomed, and some are already in place in OECD countries like the UK, Canada and New Zealand.”

“There are also many examples of allied health and other practitioners who work to a fuller scope and prescribe medicines in Australia,” says Mr Owen, “These include nurse practitioners, optometrists, podiatrists, midwives, physiotherapists and dentists.”

“One of the issues for Queensland communities is the fact that many in regional and remote areas do not have access to a hospital or a GP but do have access to a community pharmacy.”

“More than 90% of metropolitan and 67% of regional Queenslanders live within 2.5km of a community pharmacy, so it makes sense to ensure that pharmacists are enabled to do all that we can to provide vital frontline health services to Queenslanders throughout the state,” says Mr Owen.

“For long-term health system reform, the community pharmacy network needs to be empowered to reduce unnecessary hospitalisations and ensure that all Queenslanders have access to world-class healthcare.” “We welcome the report and are committed to partnering with the Queensland Government to make it a reality.”

 A copy of the full report can be found here:https://www.health.qld.gov.au/__data/assets/pdf_file/0029/1143479/Unleashing-the-Potential-an-open-and-equitable-health-system.pdf

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“We know that for some surgeries, including hip and knee replacement surgery, waitlists were already two to three years in some areas. The latest Covid-19 outbreaks have further impacted these waitlists, with thousands of surgeries delayed and patients having to continue living with immobility and debilitating pain, not knowing when they will be able to have the surgery done,” says Lloyd Adams, Executive Manager for Healthcare Care Australia.

Prior to the recent outbreaks in New South Wales and Victoria, private hospitals were already shouldering some of this burden, supporting the public system to reduce their waiting lists, particularly with surgeries such as cataracts, colorectal surgery and orthopaedic surgery.

According to Mr Adams, despite remaining in a ‘holding pattern’ to allow capacity for further surges in Covid-19 cases, the private sector remains ready and willing to ‘pick up the slack’, while also continuing to support those patients who have retained their private health insurance.

However, he highlights that for those patients without private health insurance, choices are limited. Some opt to go privately, shopping around and paying the ‘self-insured’ rates charged by surgeons, while others have previously been forced to look overseas for surgery packages in places like Thailand or Bali.

Healthe Care is now providing a third alternative to lengthy public hospital waitlists for those without private health insurance, with Self Pay Surgery.

“The Self Pay Surgery program has been designed as a way for patients without private health insurance to access the surgery they need, with an accredited surgeon, close to home, in a quality private hospital. For some patients, this means they can now have their surgery privately rather than being part of a long public waitlist, while for others it means accessing surgery that isn’t available publicly.

We launched Self Pay Surgery back in 2020 and have now seen hundreds of patients across our Healthe Care hospitals. As we continue to add more surgeries and locations, Self Pay Surgery will ensure that patients have another option available, allowing them to get back on their feet sooner,” says Mr Adams.

As the name suggests, ‘Self Pay Surgery’ provides patients with an alternative to public hospitals for those without private health insurance, by ‘packaging’ up surgery products at a single affordable price. The Self Pay Surgery packages include the surgeon’s fees, anaesthetist, hospital stay, diagnostic testing and rehabilitation (where appropriate), taking away the leg work and confusion from wary patients.

The Self Pay Surgery packages currently on offer include same day procedures such as gastroscopy, colonoscopy, wisdom teeth and cataract surgery, through to more complex orthopaedic procedures including total knee and hip replacement surgery, shoulder arthroscopies and weight loss surgery.

With ‘buy now, pay later’ options including Open Pay, Zip, and Humm, prepayment plans or even the option to access Superannuation to fund essential surgery, the financial burden of private surgery has even been considered.

“Self Pay Surgery isn’t about jumping the queue or cutting corners, it’s about offering patients more options and the flexibility to have their surgery privately, with an experienced surgeon and surgical team.

With Healthe Care hospitals located throughout the NSW Mid North Coast, Hunter, Central Coast, Sydney and Illawarra regions, along with Victoria and Tasmania, Healthe Care is well positioned to provide this much needed alternative to the traditional public health and private health services, helping to ease the burden for both the healthcare sector and long suffering patients,” says Mr Adams.

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The National sports injury data strategy is a draft consultation that outlines how a National Sports Injury Data Asset (NSIDA) could be developed and operate.

Also today, the AIHW is releasing the first stage of work, Economics of sports injury and participation – Preliminary results, aimed at better understanding the potential savings to be gained through improving injury prevention and management and increasing physical activity across the Australian population.

This report suggests that around three quarters of a billion dollars is spent each year on managing relatively severe injuries that were associated with inadequate injury prevention and management during physical activity ($764 million in 2018-19).

This report also suggests that conditions associated with physical inactivity cost the health system close to one billion dollars each year ($968 million in 2018-19).

Demonstrating the savings that can be achieved, however, it is estimated that health spending could be as much as half a billion dollars higher if the Australian people were less physically active (at least $484 million in 2018-19).

“Australia is a sporting nation and participation in sport improves our health and wellbeing, however, these benefits are often lessened as a result of injuries that could either have been prevented or better managed,” says AIHW spokesperson Dr Adrian Webster.

In partnership with Sport Australia and the AIS, the AIHW is investigating the existing and potential data sources that could be used to improve sports injury prevention and management. The aim is to investigate how a NSIDA could:

• Provide insight into the types and causes of sports injury in the community.
• Help sports bodies and their participants to understand where injury prevention programs are needed.
• Provide ongoing surveillance to monitor trends and evaluate injury prevention programs.

As part of this project, the AIHW is talking with sports organisations, health-care providers, insurers and government agencies to understand what sports injury data is currently being collected.

Additionally, a new online sports injury data collection tool is being piloted to fill a gap in community sports injury reporting. This tool can be used by players, parents, coaches and trainers to record injuries.

“It is hoped that piloting this tool will help us learn how best to collect data on community sports injuries,” says Dr Webster.

A pilot project will be rolled out by mid-2022 for use on smartphones, tablets and computers.

Feedback on the proposed data strategy can be emailed to injury2@aihw.gov.au or by calling the project team on (02) 6249 5292 until 18 April 2022.

The AIHW will release, Hospitalised sports injury in Australia, 2019–20, in March 2022.

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Malignant migrating partial seizures in infancy (MMPSI) is a childhood epilepsy most commonly caused by mutations in the KCNT1 gene – a gene responsible for regulating neuron activity in the central neural system. Children with this genetic condition are very unwell and can suffer up to 100 epileptic seizures a day.

There is no cure or current therapy to relieve the condition and the research aims to change this.

Researchers will work with European collaborators to investigate a range of drugs flagged as possible options for children with MMPSI, testing their effectiveness on reducing seizures.

Chief investigator UniSA’s Professor Leanne Dibbens, is an expert in the genetics of childhood epilepsy and was involved in the first discovery of the genetic mutations that cause epilepsies including MMPSI. She says that this research could deliver life-changing outcomes for affected children and their families.

“Children with MMPSI are very unwell, suffering multiple seizures every day,” says Professor  Dibbens.

“The disorder affects brain development, which means these children also have very impaired motor skills and severe intellectual disabilities.

“The non-seizure drug Quinidine has been trialled in a number of children, but with little improvement, so there’s an acute need for new drugs to treat children with KCNT1 mutations.

“We will be investigating a range of FDA-approved drugs that have been identified to limit the effects of the potassium gene mutation, and in this way, we hope to identify a high potential drug to treat this type of severe epilepsy.”

A significant advantage of the study is the eight drugs within the study are already FDA-approved, which means the need for lengthy and costly clinical trials to prove the drugs’ safety and efficacy are eliminated.

Positive results from this study will make a strong case for trialling the drugs in people with KCNT1-epilepsy, with children suffering from this severe form of epilepsy having immediate access to successful drugs.

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The report from the Australian Institute of Health and Welfare (AIHW) shows the number of younger people in permanent residential aged care decreased in every state and territory between 2020 and 2021.

“The Australian Government has set targets to have no people under the age of 45 living in residential aged care by 2022, and under the age of 65 by 2025 (other than in exceptional circumstances), through the Younger People in Residential Aged Care Strategy 2020–25, released in September 2020. Today’s [Thursday 10 Feb] report tracks progress against these targets over the past year,” says AIHW spokesperson Louise York.

“The goal of the Strategy is to reduce the number of younger people entering residential aged care and support those already living in residential aged care to move into age-appropriate accommodation with the supports they need.”

From July to September 2021, 151 people aged under 65 entered permanent residential aged care, a 30% decrease from the same period in 2020. The decrease in admissions has resulted in lower overall numbers of younger people living in residential aged care.

The number of younger people living in residential aged care ranged from 10 in the ACT to 1,184 in New South Wales.

In September 2021, just over half (53%) of the younger people living in residential aged care were male and 10% were identified as Aboriginal and/or Torres Strait Islander. The majority (59%) of younger people living in residential aged care were aged 60–64. Nearly four in 10 (39%) were aged 45–59, and 2% were aged 18–44.

The AIHW will continue to report on the number of younger people living in permanent residential aged care on the GEN Aged Care Data website.

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Health authorities are now being called upon to start collecting data on both negative and positive rapid antigen test results, to better monitor the pandemic.

Data indicates the Therapeutic Goods Administration (TGA) has received 114 complaints about rapid tests, with 94 relating to those used in laboratories or point-of-care environments such as workplaces, and aged and residential care facilities, and just 20 reports related to self-tests, which became available for home use in November 2021.

Graham Gordon CEO of Gardian and developer of Gardian Test Tracker and the Self Check app, believes it is important that people understand their underlying risk of developing Covid-19 and the differences between products before using rapid antigen tests.

“In addition to their actual exposure to someone with Covid-19, whether they have been in a venue where there have been positive cases, whether they’ve been vaccinated, and if they’ve had any symptoms, there are a further six key reasons why you may receive a false negative or false positive and most of them relate to how they undertake the test.”

With an estimated 90% of the population glossing over instructions assuming most of it can be figured out by using common sense, health officials are advising people that not all products are created equal – varying from moderately to very highly sensitive – and that following the prescribed directions is vital to getting a valid test outcome.

Storage and stability

Irrespective of what format or brand it is, a rapid antigen test is an in vitro diagnostic device and should be stored in a cool (not frozen) and stable temperature. One cannot obtain a rapid antigen test from the pharmacy and then leave it in a hot car for half an hour while you purchase groceries or have coffee with a friend. Rapid antigen tests should be stored between 2 and 30 degrees Celsius, kept away from direct sunlight, moisture and heat. There are also expiry dates that need to be adhered to.

Hygiene and safety measures

Prior to starting the test, the instructions for use will instruct the user to have a clean, flat surface on which to work and to wash their hands with soap and water or use a hand sanitiser, but they may not stipulate that there is a specific way to remove the swab and the test cassette without incurring contamination. Once again, users should bear in mind that the test is a medical procedure, and the conditions should be kept as sterile/clean as possible.

Time allocations

Every rapid antigen test has specified time restrictions and allocations relating to a correct procedure, whether that be the time period that one should not smoke, eat or drink prior to a test, how long the cassette or swab should be used or the waiting period before interpreting the result. There is even a time limit for how long one can have the test open prior to testing, and how long the test is valid for. The instructions for use are specific for a reason and should be followed to the letter.

Collecting the sample

The physical process of collecting a sample is not always as simple as it seems. Nasal samples may be collected from different areas of the nasal passage, and they are not all correct. Based on the images of people undergoing PCR tests, some people believe that the sample should be collected from the top of the nose, but the ideal sample is one collected horizontally just above the nostrils, approximately 2cm in. Obviously, if the sample is not collected properly, one cannot achieve a true result.

Transference of the buffer solution

Seemingly simple, but next to collecting the sample, this step may be the most challenging for users. Most rapid antigen tests include a pipette that needs to be twisted open and the buffer solution transferred to a plastic vial. If the solution is spilled or shaken at all there may not be sufficient solution to detect the virus, and any bubbles generated may interfere with the result.

Furthermore, for those with any form of finger weakness, dexterity or vision problems, the manual handling of a multiple step process may be challenging. Placing too few or two many drops of the sample solution onto the cassette may impact on the result.

Cassette sensitivity

Once placed on the clean, flat surface with the ‘reader’ facing upwards, the test cassette should not be touched until the allocated time has passed and the result has been identified. All too often, the cassette is picked up and moved or reviewed before it should be, and this can lead to inaccurate performance.

Ultimately, any one of these factors, or a combination thereof, could lead to a false or invalid result.

“The biggest risk with rapid antigen tests is when people are falsely reassured by a false negative, adds Mr Gordon. “If they are to undertake any behaviour that could facilitate spread, that would be a serious thing for everybody.

“Obviously, if you think you’ve got a reasonable or a high risk of having Covid-19 because you have symptoms or are living with someone with Covid-19 and you have a negative rapid antigen test, then that may be a false negative. You should take precautions and retest within 24 or 48 hours or get a PCR test.”

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The WA Children’s Hospice will be jointly funded by the Federal Government, the WA State Government and the Perth Children’s Hospital Foundation, with the Government committing $7.5 million towards the project.

Health Minister, Greg Hunt, says hospitals could often be a stressful environment for children.

“Children’s hospices help to reduce the stress of a very difficult time by offering a more home-like atmosphere and allow families to stay together,” says Minister Hunt.

“Children’s hospices can also offer therapies and activities not easily accessible in hospitals and mainstream hospices, such as respite care, outdoor play, child appropriate nutrition and meals, multi-sensory play and onsite hydrotherapy.”

The WA Government, in partnership with the Child and Adolescent Health Service (CAHS) and the Perth Children’s Hospital Foundation, will build WA’s first children’s hospice.

The WA Government has transferred the land at Swanbourne to the Child and Adolescent Health Service, and has provided $3.2 million for project planning and design.

The Foundation will provide funding for the construction, fitout and ongoing non-operational costs of the hospice, while CAHS will be responsible for governance, management and ongoing operational clinical and support services funding.

Dr Rosanna Capolingua, CAHS Board Chair, says the service welcomed the investment from the Government towards the building of the first children’s hospice in the state.

“This facility is such an important and much-needed service for children living with a life-limiting illness, and their families,” says Dr Capolingua.

“The CAHS Board would also like to acknowledge the work the Perth Children’s Hospital Foundation has done in connecting with generous donors in our community enabling this hospice to be built on land provided by the WA Government.

“Having a dedicated facility in close proximity to WA’s tertiary children’s hospital, with top-class medical equipment and expert staff, in a beautiful setting overlooking the Indian Ocean, will provide some of our most vulnerable children and their families with much-needed respite and support.”

“On behalf of the Perth Children’s Hospital Foundation, I want to thank the Australian Government for this incredibly generous donation that recognises the need for a hospice for young palliative care patients and their families,” says Ian Campbell, Chairman, Perth Children’s Hospital Foundation.

“This funding, on this one exciting day, moves the WA Children’s Hospice from dream to reality, providing the biggest single financial contribution alongside our other donors, large and small. We can now look forward with confidence to start building in Swanbourne in a few short months’ time,” says Mr Campbell.

The WA Children’s Hospice will provide palliative out-of-home respite care and support for children and families.

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Researchers from Monash University say the findings warrant further research into the potential benefits of testosterone therapies for older women.

Before menopause, women’s ovaries are the primary source of testosterone circulating in the blood. After menopause, because the ovaries stop functioning, blood testosterone is made from the hormone DHEA which comes from adrenal glands.

Using data captured in the longitudinal ASPREE (ASPirin in Reducing Events in the Elderly) randomised trial, this study, led by Susan Davis, Professor of women’s health in the Monash School of Public Health and Preventive Medicine, measured blood testosterone, DHEA and oestrogen concentrations in women over 70 with no prior CVD events.   Women who had low blood testosterone and DHEA concentrations but not low estrogen, had twice the risk of a cardiovascular event than women with higher testosterone blood levels.

Blood testosterone levels decrease with age in women from their early 20s but do not change significantly as a result of natural menopause.  However, after the age of 70 years, women have blood testosterone levels similar to those seen in young premenopausal women.

Professor Davis says the findings suggest there might be some advantage to older women having high testosterone levels.

“We have shown in past studies that testosterone therapy lowers blood pressure and increases blood flow in arteries. So, our hypothesis was that having higher testosterone may protect older women from cardiovascular disease, which is contrary to the conventional belief that testosterone is bad for the cardiovascular system,” says Professor Davis.

“We need to stop thinking about testosterone as a ‘male’ hormone that is bad for women. It is an important human hormone for both women and men.

“Further research is needed to better understand testosterone action in blood vessels and the heart, including whether treating postmenopausal women with low testosterone protects against cardiovascular disease.”

The Sex Hormones in Older Women (SHOW) study incorporated results from  9180 Australian women, aged at least 70 years, with no prior CVD events of which 5535 were included in this analysis with a median age of 74 years.

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