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print an article you can do so from that specific page, otherwise, from this page you Violence Against GPs |
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Violence Against GPs
This article is a follow up to the article and survey sent out in the Northern Pulse on the 28th October 2009. Violence and aggression is underreported in general practice and little has been known about its severity until now. Source: VicDoc, December 2009. AMA Victoria Communications and Public Affairs Officer Francesca Jackson-Webb reports. Patients seeking urgent medical care can be at their worst - anxious, short tempered and in pain - and when they become violent it is often the healthcare workers trying to help them who bear the brunt of this aggression. The threat of violence in emergency departments is treated seriously, with research and planning to reduce the threat of harm to hospital staff. But violence in general practice is under reported and is often just seen as one of the shortcomings of the job. Nearly two thirds of Australian GPs have experienced some form of violence in the past year, with staff commonly encountering aggressive patients who are verbally abusive, threatening, and who cause damage to property. Preliminary findings from the Australian National University's (ANU) research on violence in general practice, released in October, found that violence was often triggered when patients were told they had to wait to see a doctor or when practices discontinued bulk billing or raised fees. The Commonwealth Department of Health and Ageing commissioned the Australian Primary Health Care Research Institute (APHCRI) at ANU to find out what was behind a largely unreported wave of violence in general practice. "So far we have found that aggressive patients are part of their everyday working life." says research leader Associate Professor Rhian Parker. "General practice staff - particularly receptionists - are frequently abused by patients." The researchers found that while aggression occurred at all times of the day, high-level violence, such as physical abuse, sexual harassment and stalking, was more likely to occur after hours. "This obviously has implications for training staff, as some of them are being worn down by these experiences," says Assoc Prof Parker. "What we need to do now is find out the extent and impact of this aggression." The preliminary findings were used to develop a national online survey for GPs and practice managers, which closed last month. The ANU data follows 2005 research from Dr Parker Magin and his colleagues at the University of Newcastle, which showed that violence in general practice was significantly more likely to be directed at female GPs, less experienced doctors and those working after hours and in areas of social disadvantage. Dr Magin concluded that formal education programs in preventing and managing violence were needed for GPs and doctors in training. Melbourne GP Dr Leanne Rowe, co-author of the doctors' health and wellbeing handbook 'First do no harm', says general practice needs to catch up to other professions' standards of violence management and prevention. "As doctors, we are very focused on patient care," says Dr Rowe, "often to the detriment of our own health and our own safety." She says GPs and their practice staff need to be trained to identify, manage, and prevent the threat of assault in private practice. Knowledge of de-escalation techniques, violence management plans, and safe environments are essential. Practice layouts need to be planned with violence minimisation in mind: barriers to prevent aggressive patients directly accessing consulting rooms, window and door locks, shatter-proof glass, bright outdoor lights, high fences and duress alarms. Dr Rowe says doctors should consider seating themselves closest to the door of their consulting room so they can escape if a patient's aggression escalates, or inviting an observer into the room to help diffuse a potentially violent situation. There is a fine line between difficult behaviour and assault, Dr Rowe admits, but whenever a doctor or practice staff member "fears immediate or unlawful violence", this constitutes assault and should be treated seriously, with appropriate interventions. "We must recognise the point at which strong emotion tips into threatening behaviour," says Dr Rowe. Four Australian GPs have been murdered at work in the past twelve years. One of those GPs was Dr Khulod Maarouf-Hassan, a close friend and colleague of Dr Rowe. Dr Marrouf-Hassan's attacker had developed a delusion that the medical profession was trying to kill him. He had sought help from several services in the months before he attacked Dr Marrouf- Hassan in her Noble Park clinic in June 2006. Last year 25 year-old Samuel Benjamin was found not guilty of Dr Marrouf- Hassan's murder due to mental impairment and was sentenced to 25 years in a secure facility. "We should be learning lessons from all those deaths," says Dr Rowe. Managing patients at risk of violence can prevent these kinds of attacks. Patients at risk of violence should be reported to the police, and this sets the motions in train to secure specialist mental health care for the patient. Dr Rowe argues that other practices should be warned about patients with a past history of violence but acknowledges patient confidentiality requirements make this difficult. For Rowe, the answer to reducing violence in general practice is empowering GPs and their staff by training them to deal with the threat of violence and aggression in their clinics. "The solutions are actually there. In any other area of medicine, that's what we do: we offer training and make sure people are skilled."
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Changes to Medicare Primary Care Items for GPs
This fact sheet sets out the changes to Medicare attendance items for vocationally-recognised General Practitioners (GPs) as a result of the Medicare Benefits Schedule (MBS) Review which will be effective from 1 May 2010. These include changes to: To view read the full changes please Click Here. |
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Accredited Mental Health Training Update
The 2009-10 Federal Budget included the introduction of a new Medicare item for GPs who have not completed accredited Mental Health Skills Training from 1 January 2010. An outline of the Budget measure and a definition of Mental Health Skills Training was provided in the previous fact sheet circulated in early October 2009, which can be found at: www.health.gov.au/internet/main/publishing.nsf/Content/mental-ba-train What is the new MBS item for GPs who have not completed Mental Health Skills Training? As of 1 January 2010, a new Medicare item (2702) will be introduced for GPs who have not completed accredited Mental Health Skills Training, with a schedule fee of $125.95 for developing a Mental Health Treatment Plan. GPs who have completed Mental Health Skills Training accredited by the General Practice Mental Health Standards Collaboration (GPMHSC) will continue to be able to access item 2710, with a current schedule fee of $160.45 for developing a Mental Health Treatment Plan. What are the requirements for new item 2702? The requirements for new item 2702 are the same as for item 2710. In developing a Mental Health Treatment Plan under either item number 2710 or 2702, GPs are required to undertake a comprehensive assessment of the patient’s mental health needs, and record that assessment and diagnosis in the Plan. In order to claim the above items GPs must undertake this assessment of their patient and develop the Plan themselves, in consultation with the patient. How will Medicare Australia know which item number I can claim? By 11 December 2009, the GPMHSC will provide Medicare Australia with a list of those GPs who have completed the requisite training and are therefore eligible to access the higher schedule fee. Those GPs who are not on this list will only be able to access the new item 2702 with a lower schedule fee. After that time, the GPMHSC will continue to advise Medicare Australia on a regular basis the names of GPs who have completed accredited Mental Health Skills Training. IMPORTANT: The GPMHSC will provide GP contact details including e-mail address and/or postal address to Medicare Australia to expedite the registration process and allow them to inform GPs of their eligibility to claim MBS item 2710. GPs who do not wish for this information to be provided to Medicare Australia must contact the GPMHSC before 11 December 2009. After I have completed the training, how quickly can I use the 2710 item? The GPMHSC will provide information to Medicare Australia that a GP has completed Mental Health Skills Training. Medicare Australia will then record the date the training was completed as the effective date advised by the GPMHSC. Medicare Australia will notify the GP of the effective date soon after receiving this date from the GPMHSC. Please note there will be a time lag from when a GP’s completion of training has been provided to the GPMHSC and reported to Medicare Australia – this may be anywhere from two to six weeks. A GP who has completed the relevant training should hold accounts for item 2710 until they receive the confirmation of eligibility from Medicare Australia, and can then submit these claims to Medicare. What if I claim the wrong item number? If a GP who is not registered with Medicare Australia as having completed the training claims an item 2710, Medicare Australia will reject the claim. The Medicare system will not automatically default to a 2702 item. If a patient takes a claim for a 2710 to Medicare Australia for reimbursement, and the GP who prepared the Plan is not registered with Medicare Australia as having completed Mental Health Skills Training, the Medicare system will not allow this to be processed. The patient will be required to return to the practice and have the correct invoice issued for a 2702 item and return to Medicare to process this new claim. How can I confirm that I am registered as having completed Mental Health Skills Training? If you are unsure whether you have completed Mental Health Skills Training, you should contact the GPMHSC to check whether you have done so on (03) 8699 0554/0556 or at gpmhsc@racgp.org.au. If I am yet to complete Mental Health Skills Training, how can I find out what courses are available in my area? There are a number of ways to find available Mental Health Skills Training courses. You could visit the GPMHSC’s find training page at www.gpmhsc.org.au, or contact the GPMHSC on (03) 8699 0554/0556 or your College or local Division of General Practice. GPs are encouraged to complete their Mental Health Skills Training as soon as possible. Please note that some providers of online courses may be closing down for the Christmas period, which may impact on the availability of help desk support staff to assist GPs with their online training requirements during this time. Please check with your preferred provider the availability of support for online courses during December. What if I have already completed Mental Health Skills Training? If you have completed a GPMHSC accredited Mental Health Skills Training course since 1 July 2001 (previously known as level 1 mental health skills training) and your attendance at this course has been registered with the GPMHSC, you do not need to do this training again to qualify for the higher schedule fee. However, continuing professional development (CPD) in mental health skills training is strongly encouraged, and the GPMHSC recommends six hours of mental health CPD each triennium. If you are unsure whether you have completed Mental Health Skills Training, you should contact the GPMHSC to check whether you have done so on (03) 8699 0554/0556 or at gpmhsc@racgp.org.au. What if I have not completed Mental Health Skills Training but consider I have obtained requisite skills through other training pathways? Any GP who has completed accredited Mental Health Skills Training since 1 July 2001 will not be required to do so again to continue to access the higher schedule fee. However, in addition to completing this Mental Health Skills Training, all GPs are encouraged to further maintain their competencies by undertaking CPD in mental health. Any GP who considers that they have gained the requisite mental health skills listed for Mental Health Skills Training through other training pathways, including tertiary qualifications, may make an individual application to the GPMHSC for Mental Health Skills Training accreditation. You should contact the GPMHSC on (03) 8699 0554/0556 or at gpmhsc@racgp.org.au to discuss an application. If on reading this fact sheet you have any further queries, please contact CAT 1 CPD = 40 CPD points - MHST = old Level 1 initial http://www.racgp.org.au/gpmhsc/findtraining
The Adelaide Northern Division of General Practice are running a Mental Health Skills Training Session. Saturday 27th February 2010 This session aims to; Click Here to view/download flier for ANDGP Mental Health Skills Training
Online Accredited Mental Health Skills Training: • Young Minds (free) – www.ebmcbt.com Treating depression and anxiety in young people training package. Includes up-to-date clinical information and guidelines for diagnosis, treatment and management, fact sheets and advice on how to create a ‘youth friendly’ practice. Approved by General Practice Mental Health Standards Collaboration; endorsed RACGP, ACRRM, RCNA and AASW. • Think GP (Free) - his course is accredited by the GPMHSC as a Mental Health Skills Training (MHST) program. Update and enhance your diagnosis and management of 6 key mental health areas handled in General Practice. http://www.thinkgp.com.au/education/124735 • Med-e-serv (fee applies) – www.primed.com.au Short course, Mental Health Skills for GPs. • Mental Health Skills Training (MHST) – ACCRM - Mental Health Disorders Package for Rural Practice Level 1 Core Skills Module Contact: Karen Felsh, 07 3105 8200, k.felsh@accrm.org.au • Mental Health Skills Training (MHST) Genesis Ed Online Mental Health Skills Training- Creating a team approach to treatment and planning care Contact: Dr John Crimmins, 02 9870 8044, j.crimmins@genisised.com.au Online Accredited FPS CPD: • Focussed Psychological Strategies CPD (FPS CPD) Lifeblood Cognitive Behaviour Therapy Refresher Course Online - Contact : Christina Koniaras, 03 9804 0777, christina.koniaras@lifeblood.com.au Face to Face Mental Health Skills Training Workshops: Face to Face Focussed Psychological Strategies Workshops: • Mental Health Skills Training (MHST) & Focussed Psychological Strategies Skills Training (FPS ST ) The College of Medical Hypnosis Clinical Course in Hypnosis & CBT, Contact : Lindy Hope , 02 9688 2300, info@mindperformance.com |
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Immunisation Update
Changes for Non Accredited GPII Practices. Non accredited GPII practices would have recently received a letter from the Department of Health and Ageing and Medicare Australia. This letter outlines the changes to the General Practice Immunisation Incentive scheme relevant to these practices following announcements made in the 2009-2010 budget. This budget item aims to improve quality and safety in vaccine management. From August 2010, practices will need to have appropriate processes in place that maintain the potency of vaccines. The specific requirements that practices will need to meet are outlined in The Australian Immunisation Handbook, Chapter 1.3.2 of the 9th edition. Practices should use the information in the Handbook as a self-assessment tool to determine whether they meet the vaccine management guidelines. General practices will also be required to have current public liability insurance and all GPs working from the practice will be required to have professional indemnity cover. Practices currently participating in the Practice Incentives Program (PIP) will be automatically considered to meet the entry requirements relating to vaccine management, public liability insurance and professional indemnity cover. A further letter will be sent by Medicare Australia in February 2010 with an application form to be returned to Medicare Australia confirming that they meet the new GPII requirements. A third mail out will occur at the end of March 2010. This mail out will be to practices that have not responded to the February 2010 mail out. Practices that have not returned the GPII interim application form by 30 April 2010 will not be eligible to receive an outcomes payment in August 2010. Information from the AGPN – The Finer Point No 145 November 2009 Website: http://www.agpn.com.au/programs/immunisation/newsletters/the-finer-point For more information please contact Bronwyn Myles at the Division on 8252 9444.
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GP Directory 2010
The Division is putting the finishing touches to our GP Directory 2010. Each year we compile a directory of general practices and GPs within the area along with contact information for pharmacies and other services. The directory also provides information about the Division’s services and features each general practice listing their GPs, languages spoken, services provided, opening hours, contact information and a detailed map showing how to find the practice and public transport options. In the coming weeks each practice will receive a rough copy of their page. We ask that you correct any inaccurate information and confirm that the services on offer are correct before returning the page to us. If this is not done then the information included in the directory for your practice may be out of date. This valuable resource is distributed free of charge to every general practice and aged care facility as well as other relevant organisations within the Division. A copy is given to each GP in the northern suburbs and Barossa as well as, upon request, medical representatives. The directory is also available as a downloadable public resource through our website. Previously we have printed this directory in-house, however, since this is a very popular and widely recognised resource, we now wish to have this directory professionally printed with funding provided by the sale of advertising space. If you are interested in buying advertising please contact Ed Garner by calling the Division on 8252 9444 or emailing egarner@andgp.org.au |
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New Palliative Care Online Forum
The Division has launched a new palliative care forum. The goal of this forum is to provide staff with an opportunity to share information, knowledge and to establish links with one another. This forum will be regularly updated with columns from a variety of contributors, palliative care resources and information, links to newsletters and articles from a wide variety of sources, upcoming events, on line education and the opportunity for discussion. As you use the forum we invite you to share your experiences and challenges, ask your colleagues questions and share what you have found works in different situations. There is a hidden section of the forum available only to GPs. If you are a GP and would like access to view and post here please email egarner@andgp.org.au with your username after you have registered. To register on the forum We ask that you remain mindful of privacy and confidentiality when posting to the forum. Posts that contain potentially identifying information and/or offensive information will be removed. The forum will feature regular columns from contributors. If you would like to contribute please email Christine Churchill cchurchill@andgp.org.au This site and all posts will be moderated and we reserve the right to remove or refuse access to this site. Posts in relation to medication queries are not permitted. If you would like any more information please contact;
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Obstetric Shared Care
GP partners Adelaide is now managing on behalf of all SA Divisions the statewide GP Obstetric Shared Care (SA) Program funded by the Department of Health. Dr Suzi Pedler and two other previous Divisional GP Advisors are overseeing the running of the program. What is the Statewide Obstetric Shared Care Program? - South Australian Program managed by General Practice partners Adelaide (GPpA) and
funded by the Department of Health. How do I apply to become an accredited GP Obstetric Shared Care Provider or find out more about the program? - Visit the GPpA website: www.gppadelaide.org.au and download the GP Application Form for Obstetric Shared Care Accreditation. Email gppa@gppadelaide.org.au for further information. What are the criteria for accreditation to the program? - At least 3 months of previous hospital obstetric experience OR A series of antenatal clinical attachments arranged by the program. What is required to maintain accreditation to the program? - Attendance at one whole day Accreditation Seminar per triennium OR Attendance at two Obstetric Shared Care Program two hourly educational events per triennium. For further information please contact the GPpA by phoning 8112 1100. |
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Health Resource Project
The Health Resource Project is a partnership project between Helping Hand Aged Care and Ethnic Link Services. It explores the resource needs, and barriers to access, for older people from culturally and linguistically diverse communities (CALD) in participating in chronic disease self management support interventions. This project is focused on northern metropolitan Adelaide. Through a range of activities including focus groups, interviews and surveys, we aim to develop a relevant and useful resource to improve the way we work with CALD communities in the area of chronic disease self management. Your support and contribution to this project are greatly appreciated. Please Click Here to Download and Complete the Survey Please email finished surveys to kmackenzie@helpinghand.org.au For more information please contact Kirsten MacKenzie (Project Coordinator) / Neda Bojnoordi (Co Coordinator) 8241 9061 or kmackenzie@helpinghand.org.au
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Privacy is Key: New Legislation and General Practice
Source: Media Release RACGP 14 January 2010 The General Practice Data Governance Council met in Canberra in December 2009 to progress the key data governance agenda related to health privacy. The peak general practice organisations have formed the General Practice Data Governance Council, a new body to oversee the use of general practice data collected from participating practices, in August 2009. A briefing was provided about the proposed new privacy legislation and its impact on general practice by senior staff from the office of Prime Minister and Cabinet. The major focus was on proposed reforms to the Privacy Act that will see a single set of privacy principles across the public and private sectors, and all jurisdictions. This would streamline the current situation where public organisations are covered by the Information Privacy Principles and the private sector, including general practices, by the National Privacy Principles. This places the Council in a strong position to progress work regarding the governance of general practice data and continue a dialogue which was requested and welcomed by all present. “I am delighted that not only have the designers of this complex but innovative re-design sought to brief us, but they remain committed to a real and practical engagement with health practitioners who have to use and adopt this legislation,” said Council chair, Dr Mukesh Haikerwal. The primary work of the General Practice Data Governance Council is to ensure that health practitioners have sound, ethical and grounded principles from which to take guidance about the use of general practice data. The Council has been formed in response to the many data transfer activities currently planned or taking place in Australia, and is committed to profession led governance regarding the issues of data collection activities in general practice. “Data collection, storage and management have to be agreed by the general practice community with its understanding of the key drivers of privacy, confidentiality, safety, quality, ethics and accuracy”, said Dr Haikerwal. The Council includes representatives from the Australian Association of Practice Managers (AAPM), the Australian College of Rural and Remote Medicine (ACRRM), the Australian General Practice Network (AGPN), the Australian Medical Association (AMA), the Australian Practice Nurses Association (APNA), the Royal Australian College of General Practitioners (RACGP), the Rural Doctors Association Australia (RDAA) and a consumer representative nominated by the Consumers Health Forum of Australia (CHF). |
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GPs Workload Increasingly Busy
Source: Australian Journal of Pharmacy, January 2010 Pharmacists could share the increasingly complex clinical workload of general practitioners (GPs), as it was confirmed that GPs are more involved in the long-term care of more patients with complex multiple medical problems, according to the Australian Institute of Health and Welfare (AIHW) reports, General practice activity in Australian 2008-09 and 10-year data tables, released last month. 'The majority of Australians' health services are provided by GPs so the information revealed in these reports point towards long-term trends in healthcare for all Australians,' said Dr Chris Mitchell, president of the Royal Australian College of General Practitioners. Using the results of more than one million encounters between doctors and their patients, the data, collected annually for the BEACH research program, identifies 10 years of changes in general practitioners, their practices and their patients. 'The report estimates that GPs managed around 25 million more problems in Australia in 2008-09 than in 1990 to 2000. Evidence of an ageing population and an increase in the number of patients requiring care for long-term (chronic) disease means that a GP's workload is only going to increase over time,' said Dr Mitchell. 'in addition, the number of hours available for people to see their GPs is potentially shrinking as our GP workforce ages; the average age of GPs is now older than 50 years. This must be addressed through better recognition of the work of GPs. We urgently need to increase the number of doctors working in general practice and before they retire we need to harness their skills to train the next generation. Since 2000, GP supply has fallen by 2%. 'The number of general practice training places must increase by a minimum of 100 every year in order to reach the year 2015 target of 1,500 places. 'While the continued development of multidisciplinary care teams is also essential in the management of this increasing clinical workload, GPs must remain as the front-line of primary healthcare offering whole person, comprehensive and coordinated care to the community,' Dr Mitchell said View the full report at www.aihw.gov.au/publicalionsAndex.chm tige/11 g13 |
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Other News
Lyell McEwin Hospital Department of Gynaecology Physeptone 10mg Tablets supply Now Restored Sigma Pharmaceuticals wishes to advise that Physeptone 10mg tablets are now back in stock and available from your wholesalers as of Friday, 15 January 2010. Please be advised that supply of Physeptone tablets under the Special Access Scheme (SAS) Category A & B will cease at 5.00pm EST on Thursday 14 January 2010. All applications received prior to this time will be delivered via Sigma customer service. The new packaging of Physeptone tablets will show the new approved storage conditions of ‘Store below 25°C’ and a reduced shelf life of ‘15 months’. If you have further questions, please contact Sigma Medical Affairs Department on (03) 9839 2800. Free Online Cancer Training for GPs Free online cancer training modules for GPs Education Program in Cancer Care, launched late last year, is a free online cancer education and resource site for GPs. EPICC includes information on general principles of cancer, diagnosis, treatment, side effects, and symptoms of treatment, oncological emergencies, psychosocial care and follow up. The information is available online and can be completed as learning modules or accessed as informational resources. The program is funded by the Australian Government through Cancer Australia. For more information, please go to www.epicc.org.au Rural and Remote Inpatient Unit Moves Plans are in place to provide support to consumers with extra nursing staff rostered to support consumers whilst other staff support the move. Clinical and admin offices moved to the Downey building on Thursday and Friday 17th and 18th.
They will have the same contact numbers and remain Rural & Remote Mental Health Service – Inpatient Unit and Distance Consultation Service.
Introducing Glenn Roullier (Addictions Councellor) Prior to joining the Alcohol and Other Drugs Program at ‘UnitingCare Wesley Bowden’, Glenn spent eight years in the ‘Family Services Program’ and six years working in the ‘Men and Family Relationships Program at UnitingCare Wesley Port Adelaide. Because of this experience and their funding agreement, he is able to counsel clients about other dynamics other than their addictions such as anger, relationships with wives/partners and their children. Glenn is also in a position to talk to wife’s/partners and other family members with support and to help with relational difficulties they experience. Further, UnitingCare Wesley can discuss personal development issues such as esteem, insignificance, insecurity, and other areas of personal growth so that the client may move from addiction and have a sense of becoming a successful person. Glenn is free to see a client for as long as required by the needs of the client, at no cost. Clients can access the service Monday to Friday 9.00 am to 4.30 pm (except public holidays) to arrange appointments on (08) 8245 7100. Whilst not essential, Glenn likes clients to make their own appointments so that they take responsibility for their change from the start. Through counselling the client and supporting those close to the client, the client can regain a sense of belonging in their family and the community, further enhancing the sense of being a successful person. If you feel Glenn can be of service to a client or their partner or family members or should you wish to discuss anything or make referrals, please don’t hesitate in contacting him. Glenn Roullier Chronic Disease Project Qualifications If you are interested, or know of anyone who may be interested in completing one of these qualifications please let Shelley Nitschke know as soon as possible as places are limited. The only requirement for this project is that the 3 Chronic Disease Units form part of the electives of the respective course. Alternatively, you may know of some people who would be interested in completing the 3 Chronic Disease Units as a skills cluster. These will be delivered through a full 2 day workshop, at this stage dates are to be confirmed as we have 3 workshops being run in late Jan / early Feb however they are almost full so we hope to be running some more in April / May. Once again places are limited so those interested need to let me know as soon as possible. If you, or any of your colleagues have any queries, please give Shelley at Healthfirst Training Australia a call on 8445 7821. HEAL Booklets Still Available! |
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Research News
Watching hours of TV could Shorten Your Life Source: Reuters, 11th January 2010 Couch potatoes, beware. Sitting in front of the television for hours daily could shorten your life, according to an Australian study. Researchers from the Baker IDI Heart and Diabetes Institute in the state of Victoria tracked the lifestyle habits of 8,800 adults and found that each hour spent in front of the TV daily increased the risk of dying earlier from cardiovascular disease. The study, published in "Circulation: Journal of the American Heart Association," found every hour in front of the TV was associated with an 11 percent increased risk of death from all causes, a 9 percent higher risk of cancer death, and an 18 percent increased risk of cardiovascular disease (CVD) related death. "Compared with people who watched less than two hours of television daily, those who watched more than four hours a day had a 46 percent higher risk of death from all causes and an 80 percent increased risk for CVD-related death," the researchers said in a statement. The researchers said this association held regardless of other independent and common cardiovascular disease risk factors, including smoking, high blood pressure, high blood cholesterol, unhealthy diet, excessive waist circumference, and leisure-time exercises. Researcher David Dunstan said the study focused specifically on television watching but the findings suggest that any prolonged sedentary behavior, such as sitting at a desk or in front of a computer, may pose a health risk. "The human body was designed to move, not sit for extended periods of time," said Dunstan, head of the institute's physical activity laboratory in the division of metabolism and obesity. "Technological, social, and economic changes mean that people don't move their muscles as much as they used to - consequently the levels of energy expenditure as people go about their lives continue to shrink. "For many people, on a daily basis they simply shift from one chair to another -- from the chair in the car to the chair in the office to the chair in front of the television." Dunstan said the findings applied not only to individuals who were overweight and obese, but also those of a healthy weight. "Even if someone has a healthy body weight, sitting for long periods of time still has an unhealthy influence on their blood sugar and blood fats," he said. "In addition to doing regular exercise, avoid sitting for prolonged periods and keep in mind to 'move more, more often'. Too much sitting is bad for health." The researchers interviewed 3,846 men and 4,954 women aged 25 and older who underwent oral glucose-tolerance tests and provided blood samples so researchers could measure biomarkers such as cholesterol and blood sugar levels. Participants were enrolled from 1999 and followed through 2006 and reported their television-viewing habits.
Breakthrough May Pave the Way for Therapeutic Vaccines Source: ScienceDaily, 18th December 2009 t should be possible to use therapeutic vaccines to create both cheap and effective drugs for diseases like cancer and allergies. One problem in developing such vaccines has previously been the lack of adjuvants, substances that make vaccines more effective. However, there has now been a major breakthrough in this area. The study, led by scientists at Uppsala University, is published in the December issue of the journal Vaccine. Many of the treatment methods that are developed today for allergies, cancer, and autoimmune diseases are based on the use of so-called monoclonal antibodies. The cost of these protein pharmaceuticals is high, between 15 000 and 150 000 dollars per patient and year, and long periods of treatment are often needed. Therapeutic vaccines contain no pre-produced antibodies but rather stimulate our immune system to produce its own therapeutic antibodies. They are considerably less expensive to manufacture than the drugs that are now being produced. "Therapeutic vaccines that target the same molecules in the body as the various monoclonal antibodies would enable us to reduce the cost of treatment significantly, and also decrease the number of visits patients need to make to the clinic," says Lars Hellman, professor of molecular and comparative immunology at the Department of Cell and Molecular Biology, Uppsala University, who directed the study. One of the biggest problems when it comes to developing therapeutic vaccines has been the lack of so-called adjuvants, immune-stimulating substances that are added to boost the effect of the vaccine. Until now, there has been only one adjuvant that is approved for use in humans, and this substance has proven to have little or no effect when the target molecule is endogenous, that is, produced by the body itself. To develop new and more potent adjuvants, researchers from Uppsala University, in collaboration with colleagues from the Shemyakin-Ovchinnikov Institute in Moscow, have performed comprehensive analyses of various potential combinations. "We have made a very important breakthrough by managing to identify a substance that is biologically degradable and that exhibits considerably higher activity than the adjuvants that have been used in the past," says Lars Hellman. "These new and highly promising findings are an important step toward developing more cost-effective drugs for some of our major public health diseases," he says.
Antidepressants Cut Risk of Hospital Readmission for Suicidal Youth, Study Suggests Source: ScienceDaily, 18th December 2009 Suicidal adolescents who were prescribed an antidepressant medication during inpatient psychiatric hospital treatment were 85 percent less likely than others to be readmitted within a month after discharge, a new study found. The results provide additional evidence that antidepressants may play a key role in helping improve the mental health of suicidal youth, said Cynthia Fontanella, co-author of the study and assistant professor of social work at Ohio State University. The findings are especially important now, because antidepressant use dropped in 2003 after the Food and Drug Administration issued a black box warning that some antidepressants may increase the risk of suicidal behavior for pediatric patients. A black-box warning is the most serious type of warning in prescription drug labeling. "We found that antidepressant treatment had a protective effect on readmission," Fontanella said. "Although the findings are preliminary, our results should be reassuring to child psychiatrists who may have been concerned about prescribing antidepressants since the FDA warning." But another key finding from the study showed that hospitalized youth who were prescribed three or more medications from different drug classes for mental health issues had a 3-fold increased risk of being readmitted within a month of discharge. Fontanella conducted the study with Ohio State researchers Jeffrey Bridge, assistant professor of pediatrics, and John Campo, chief of child and adolescent psychiatry. Both are also associated with the Research Institute at Nationwide Children's Hospital in Columbus. The study appears in the December issue of The Annals of Pharmacotherapy. The researchers did a retrospective study of 318 Medicaid-covered adolescents who were admitted to three major psychiatric hospitals in Maryland because of attempted suicide or suicidal behaviors. They examined hospital medical records for the adolescents and recorded all medication changes -- including additions, discontinuations and changed dosages that occurred during the hospital stay. The researchers then identified which patients were readmitted to any hospital in Maryland within 30 days of their discharge. Hospital readmissions within 30 days are considered an indicator of quality of care, Fontanella said. Most readmissions or post-hospitalization suicide attempts occur during that time period. Fontanella said that this is the first study to investigate the effects of hospital medication changes and use of multiple medications on readmission of suicidal youth. "We know little about how medication is being used to treat youth in inpatient care," she said. "This is a first step in figuring out what is effective and what is not." The study found that 78 percent of the inpatients had one or more changes in their medication, typically the addition of an antidepressant, mood stabilizer or antipsychotic. About a quarter of the adolescents were prescribed three or more medications from different drug classes. That's particularly concerning since those prescribed three or more drugs were 2.6 times more likely to be readmitted within 30 days, Fontanella said. Fontanella emphasized that the study does not address the appropriateness of the medication prescriptions given to any individual patient in the study. However, she added that psychiatrists need to be "very judicious" in prescribing multiple drugs to adolescents, given the risks. "What we're advocating is more quality monitoring and help for clinicians in hospitals to weigh the risks and benefits to putting adolescents on multiple medications," she said. She noted that the researchers took into account a variety of clinical factors that may be related to the severity of illness for the adolescents in this study. That means youth who received multiple drug prescriptions weren't necessarily more likely to be readmitted within 30 days simply because they had more severe illnesses than did other patients. While multiple medications presented clear dangers to adolescents in this study, the use of antidepressants was clearly helpful to most patients. The message for psychiatrists is that they shouldn't dismiss the use of antidepressants for troubled youth, despite the FDA warnings, Fontanella said. Beginning in 2003, several antidepressants have had to carry an FDA warning that states they may increase the risk of suicide for some users. Since that warning has appeared, the use of some antidepressants has fallen or leveled off, and the suicide rate among adolescents has risen. "Our study suggests that many adolescents can really benefit from antidepressants, particularly those who are severely depressed," she said. "We have to be very careful before deciding not to use these medications." One of the problems that hospital psychiatrists face is that they don't have time to adequately monitor how their medication changes are affecting their adolescent patients, according to Fontanella. The average stay for inpatients in this study was just 8 days. "Because the treatment stays are so short, the psychiatrists and their teams are at a disadvantage. They aren't given the time to monitor the medications to see if they are safe and effective for the individuals," she said. "We need better ways to monitor patients after they leave the hospital to look for possibly adverse effects and drug interactions, and to ensure the medications are effective." The study was supported in part by The Center for Health Care Strategies, Inc., under tha Annie E. Casey Foundation's Children in Managed Care Initiative. Additional support came from the National Institute of Mental Health. |
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New Resources
Coping With Extreme Heat Information South Australia experiences long periods of extreme heat so it is important for everyone to know how extreme heat can affect their health and what can be done to reduce these effects. The Extreme Heat Guide has been created to help you prepare for extremely hot weather. It also explains the different heat-related illnesses, how they can affect you and what to do if you or someone you know is affected by heat. SA Health has also created a number of fact sheets for people who may be at additional risk from heat-related illness Printed copies of the guide is available through the Division's website or available direct from SA Health by calling (08) 8226 6000 and asking for the Emergency Management Unit. Click below to download Extreme Heat and Preventing Illness
Mental Health Detention Order Forms
4 Year Old Check Assessment Guide
Lyell McEwin Hospital Department of Gynaecology
Referral Form for Drug Arm A 12 week brief intervention program providing information, assessment, support, and referrals to individuals and families concerning alcohol and other drug issues. Ongoing regular and confidential support from a team of trained, caring, and empathetic volunteers Free support service offered in the client’s home, DRUG ARM Office, over the telephone, or at a mutually agreed location
How To Treat Social Phobia
Early Detection of Prostate Cancer in General Practice |
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Events and Training
ANDGP Mental Health Skills Training
What: This session aims to; When: 27th Feburary 2010, 9am-5pm Enhanced Seasonal Flu Program Training
What: SA Health are offering METRO Divisions, GPs and Practice Nurses free short evening information sessions regarding the expanded seasonal influenza program for 2010.
Angela Newbound is proposing to hold three sessions – one each in the north, south and centrally depending on demand. Additional sessions would be organised if there was enough interest. Aboriginal Cardiovascular Care: Integrating Services Across SA
What: Build multi-disciplinary teams to deal with the burden of cardiovascular disease.
Develop strategies to build workforce capacity.
Develop processes that support the out of hospital strategy.
Remove geographical and cultural barriers for dealing with cardiovascular disease.
Facilitate enhancement of primary and secondary prevention strategies for cardiovascular disease.
Optimise the patient clinical journey for ATSI people. Provision of Medical Care
and Forensic Services to
Adults who have been
Raped or Sexually
Assaulted
What: Short course to increase doctors’
knowledge and skills in providing
services to people who have
been sexually assaulted. It
provides an understanding of the
context of sexual violence and
the wide range of medical issues,
forensic medical examinations
and medical involvement in the
legal process. ANDGP Contemporary Management of
Aortic Aneurysms and Carotid Artery Disease
What: Cognitive-Behavioural Therapy for
Anxiety & Related Disorders Workshop I (2, 4 and 5 day program)
What: The CBT for Anxiety Disorders workshop program aims to equip Health
Professionals with an introductory knowledge of CBT as applied to the
anxiety disorders. Obstetric Shared Care Seminar for GPs
What: The session aims to enable participants to increase GP’s knowledge in the latest advances in
obstetrics and fulfilling criteria for Accreditation to the State wide GP Obstetric Shared Care
Program Immunisation - The Basics
What: The workshop will be of benefit to those who are interested in, or are involved in delivering, immunisation programs. Staff who report information to the ACIR and manage the Vaccine Cold Chain in general practice are also encouraged to attend. Non-nursing staff who attend the workshop are not required to participate in the module Vaccine Administration. Mental Health Professionals
Network What: MHPN has
been established to promote the quality of patient care, by fostering
local interdisciplinary networks of mental health professionals in the
primary care sector. The project, which is funded by the Commonwealth
Government Department of Health and Ageing. Keeping Families and Children in Mind
What: A course about providing support to families where a parent suffers from a mental illness (40 Cat 1 RACGP Points) Free Online Cancer Training for GPs
Education Program in Cancer Care, launched late last year, is a free online cancer education and resource site for GPs. EPICC includes information on general principles of cancer, diagnosis, treatment, side effects, and symptoms of treatment, oncological emergencies, psychosocial care and follow up. The information is available online and can be completed as learning modules or accessed as informational resources. The program is funded by the Australian Government through Cancer Australia. |
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 Employment opportunities are also viewable online General Practitioner Employment Opportunities
Government
International Medical Recruits
Employment opportunities are also viewable online |
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Classifieds An opportunity exists for a new GP surgery at the
Angle Vale
Shopping Centre. Earmarked as one of the boom growth regions in our
state,
Angle Vale is already experiencing huge population growth as a result
of
residential development. For further information please contact:
Rino Pancione, Centre Manager Ph: 0417 822 987
Michael Burdelof, Pharmacist Manager, Terry White
Chemists
Angle Vale Ph: 8284 8066
Busy solo practice, established for 30 years.
Averages 40 patients per day. Practice consists of 2 Contact Dr Charles Ling on 8255 5772 Ling Surgery 5
Sidney Chambers,
Elizabeth City Centre Elizabeth SA 5112
4 Consulting Rooms to Let - Ingle Farm Shared large Waiting Room with
Reception Area, 4
Consulting Rooms, Staff Room and own Toilet. Other in house established specialists include; Podiatrist, Physio, Doctors Surgery, Dentist, Pathologist & Hearing Specialist. 1 minute away from Gym, Hydrotherapy, Pharmacy and Shopping Centre. Contact Ashley Haine on 08 8256 2227 or email
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Lighten
Up
Old Dr. Carver still made house calls. One afternoon he was called to the Tuttle house. Mrs. Tuttle was in terrible pain. The doctor came out of the bedroom a minute after he'd gone in and asked Mr. Tuttle, "Do you have a hammer?" A puzzled Mr. Tuttle went to the garage, and returned with a hammer. The doctor thanked him and went back into the bedroom. A moment later, he came out and asked, "Do you have a chisel?" Mr. Tuttle complied with the request. In the next ten minutes, Dr. Carver asked for
and received a pair of pliers, a screwdriver and
a hacksaw. The last request got to Mr. Tuttle. He
asked, "What are you doing to my wife?"
"Not a thing," replied old Dr. Carver. "I can't get
my instrument bag open."
The Colbert Report - Doctors Orders Stephen thinks that the collar his doctor instructed him wear is completely unnesessary. (0.44)
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1st
Floor, T
08
8252 9444 |
F
08
8252 9433 | www.andgp.org.au
| ABN
12
061 979 048 Delivering local health solutions through general practice If you would
like anything
featured in the Northern Pulse E-News email: egarner@andgp.org.au
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