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Podcast title	Australian Family Physician audio
Website URL	http://www.racgp.org.au/afp
Description	Australian Family Physician is the official journal of The Royal Australian College of General Practitioners.
Updated	Mon, 14 Aug 2006 12:00:00 +1000
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Category	Science & Medicine
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Vote for this podcast	Currently 2.33/5 Rating: 2.3/5 (3 votes cast)
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1. Array http://feedproxy.google.com/~r... download (audio/mpeg, 2.47Mb) Description: Dr Matthew Peters discusses issues around flying and lung diseases, including COPD, asthma and sleep apnoea.
2. Array http://feedproxy.google.com/~r... download (application/pdf, 0.39Mb) Description: Commercial air travel is cheap and accessible. Many patients living ever better lives despite chronic lung disease wish to, and do, fly. Statistics tell us that misadventure is rare and that flight must be safe for the majority of people.
3. Array http://feedproxy.google.com/~r... download (audio/mpeg, 4.43Mb) Description: Associate Professor Graham Simpson talks about the investigations that are appropriate in general practice for chronic lung conditions.
4. Array http://feedproxy.google.com/~r... download (application/pdf, 0.99Mb) Description: Lung problems are common in general practice. History and examination are invaluable; however considered selection of investigations can assist the clinician to reach a diagnosis.
5. Array http://feedproxy.google.com/~r... download (audio/mpeg, 4.03Mb) Description: Dr Julia Walters discusses COPD diagnosis and management in general practice, including the important roles general practice can play now and in the future.
6. Array http://feedproxy.google.com/~r... download (application/pdf, 0.48Mb) Description: Chronic obstructive pulmonary disease (COPD) is a common condition characterised by breathlessness, cough and sputum production. However these are nonspecific, common symptoms which may be misattributed; resulting in a possible underdiagnosis of COPD.
7. Array http://feedproxy.google.com/~r... download (audio/mpeg, 3.29Mb) Description: Dr Andrew Beattie is a GP in Coffs Harbour who decided to look back at the diagnosis of breast cancer over 20 years in his practice. He discusses why he did this and what he found.
8. Array http://feedproxy.google.com/~r... download (application/pdf, 0.13Mb) Description: Breast cancer contributes the largest burden of cancer related disease in Australian women. Early detection is an important part of the general practitioner's work, with clinical audit recommended to help improve the quality of such work.
9. Array http://feedproxy.google.com/~r... download (audio/mpeg, 2.70Mb) Description: David Humphries, MBBS (Hons), FACSP, FFSEM (UK) is a sport and exercise medicine (SEM) physician and Past President, Australasian College of Sports Physicians (ACSP). He talks to Kath O'Connor the role of the SEM physician. Most sports and exercise related injuries and problems in the GP setting are relatively straightforward; GPs can contact a SEM physician for more complex issues.
10. Array http://feedproxy.google.com/~r... download (application/pdf, 0.15Mb) Description: Sport and exercise medicine (SEM) incorporates a diverse range of disciplines. These include: disease and injury prevention, management of medical problems in exercising individuals, management of soft tissue injuries sustained during exercise, and exercise prescription for improving physical fitness and treating disease.
11. Array http://feedproxy.google.com/~r... download (audio/mpeg, 1.28Mb) Description: Dr Stella Heley MBBS FAChSHM is Senior Liaison Physician, Victorian Cytology Service Melbourne. In this podcast Stella talks to Dr Jenni Parsons about the ongoing need for routine PAP screeing in young women, despite the good overall takeup of the quadrivalent HPV vaccine in this cohort.
12. Array http://feedproxy.google.com/~r... download (application/pdf, 0.14Mb) Description: This article looks at why a substantial number of young women who have been vaccinated with the HPV vaccine will still have Pap test abnormalities.
13. Array http://feedproxy.google.com/~r... download (audio/mpeg, 2.20Mb) Description: Prof Terry Bolin is Conjoint Associate Professor of Medicine at the University of New South Wales and Consultant Emeritus at the Prince of Wales Hospital. In this podcast, he talks to Dr Rachel Lee about the relationship between food and irritable bowel symptoms. Prof Bolin highlights that many of the symptoms of IBS are exacerbated by foods and that dietary review has an important role in managing IBS. Prof Bolin describes the effects of different carbohydrates such as lactose and fructose and emphasizes that symptoms are more common with excessive consumption. This podcast and the article provide information to the GP about how to assess and treat dietary components to IBS.
14. Array http://feedproxy.google.com/~r... download (application/pdf, 0.12Mb) Description: Prof Terry Bolin is Conjoint Associate Professor of Medicine at the University of New South Wales and Consultant Emeritus at the Prince of Wales Hospital. In this podcast, he talks to Dr Rachel Lee about the relationship between food and irritable bowel symptoms. Prof Bolin highlights that many of the symptoms of IBS are exacerbated by foods and that dietary review has an important role in managing IBS. Prof Bolin describes the effects of different carbohydrates such as lactose and fructose and emphasizes that symptoms are more common with excessive consumption. This podcast and the article provide information to the GP about how to assess and treat dietary components to IBS.
15. Array http://feedproxy.google.com/~r... download (audio/mpeg, 5.41Mb) Description: Wendy Brown, MBBS(Hons), PhD, FACS, FRACS is Deputy Director, Centre for Obesity Research and Education and Associate Professor, Department of Surgery, Monash University and Visiting Medical Officer, The Alfred Hospital. She discusses the LAGB procedure and the importance of follow up and a multidisciplinary approach to achieve sustained weight loss and manage problems and complications. Sustained weight loss and improved quality of life following a LAGB procedure depends on a multidisciplinary team (including surgeon, GP, nurse, dietician and psychologist) to meet patient needs of band adjustments, ongoing education about food choices and exercise, monitoring for nutritional and device complications and coping with psychological issues. Roles for the GP in the team include monitoring for ‘alert symptoms’ of volume reflux, nocturnal aspiration, regular regurgitation or vomiting which may indicate a complication; reinforce healthy eating and exercise messages; and adjusting the doses of antihypertensive and diabetic medications as weight loss occurs. When the amount of fluid in the band is optimal the patient feels satisfied with 2-3 small meals per day of solid food with weight loss of about 0.5-1kg per week and does not experience adverse symptoms.
16. Array http://feedproxy.google.com/~r... download (application/pdf, 0.30Mb) Description: The laparoscopic adjustable gastric band is a useful tool in the treatment of severe obesity. It is a safe and durably effective procedure, however, optimal results depend upon the patient participating in a process of lifelong care.
17. Array http://feedproxy.google.com/~r... download (audio/mpeg, 4.92Mb) Description: Dr Claire Dendle is an infectious diseases physician in the Department of Infectious Diseases at Southern Health, Melbourne, Victoria. In this podcast, she talks to Dr Kathryn O’Connor about what GPs need to know the assessment and management of mammalian bites. In the setting of a mammalian bite, history and examination is directed at assessing whether the bite has damaged underlying structures or is at high risk of infection. Treatment of mammalian bites involves cleaning and irrigation and a decision about the use of antibiotics. Primary wound closure is usually only recommended in selected wounds where cosmesis is an issue. Patients should be provided with detailed instructions and reviewed after 24-48 hours. GPs have an important role in secondary prevention of animal bites.
18. Array http://feedproxy.google.com/~r... download (application/pdf, 0.24Mb) Description: Mammalian bites are a significant public health problem in Australia, with the majority of bites coming from dogs. Complications include tissue damage from the bite itself, infection and post-traumatic stress disorder.
19. Array http://feedproxy.google.com/~r... download (audio/mpeg, 3.24Mb) Description: Dr Danille Esler is a general practitioner and Senior Public Health Registrar at Cairns Public Health Unit in Cairns, Queensland. In this podcast, she talks to Dr Kathryn O’Connor about what GPs need to know about the clinical and public health ramifications of Dengue. The epidemiology of Dengue fever has changed in recent years and there has been a recent outbreak of the disease in northern Queensland. GPs can find out about recent outbreaks on the websites of the World Health Organisation, Centers for Disease Control and, in the case of outbreaks in Queensland, Queensland Health. Most commonly, Dengue presents as a debilitating illness lasting 7-10 days. The GP role involves exclusion of other illnesses such as malaria, appropriate diagnostic testing, monitoring for the development of Dengue Haemorrhagic Fever (DHF) and prevention of spread. Dengue is a notifiable disease; if a general practitioner suspects dengue, early notification is vital.
20. Array http://feedproxy.google.com/~r... download (application/pdf, 0.24Mb) Description: Dengue virus infection is spread by the mosquito vector Aedes aegypti and causes significant morbidity and mortality worldwide. In Australia, it is an important cause of fever in the returned traveller and recent outbreaks have occurred in northern Queensland. A comprehensive understanding of the clinical and public health ramifications of dengue infection is essential for general practitioners.
21. Array http://feedproxy.google.com/~r... download (audio/mpeg, 4.10Mb) Description: George Braitberg is Professor of Emergency Medicine at Monash University and Director of Emergency Medicine at Southern Health, Melbourne, Victoria. In this podcast, he talks to Dr Kathryn O’Connor about what GPs need to know the assessment and management of spider bites. He discusses problems with spider identification, the importance of toxindrome recognition and the controversy surrounding necrotizing arachnidism in Australia. In addition, he describes the clinical effects and treatment of redback and funnelweb spider envenomation.
22. Array http://feedproxy.google.com/~r... download (application/pdf, 0.38Mb) Description: Spider bite is common, but most species cause minimal or no effects. Patients may be misinformed regarding the nature and consequences of a bite. Understanding the current literature can assist the physician in the management of spider bite patients.
23. Array http://feedproxy.google.com/~r... download (audio/mpeg, 2.46Mb) Description: Dr Geoffrey Spurling talks to Dr Rachel Lee about what GPs need to know about screening patients for retinopathy. Geoffrey highlights that a quarter of Australians with diabetes are not appropriately screened. He outlines the factors involved and describes who to screen and how often they require screening.
24. Array http://feedproxy.google.com/~r... download (application/pdf, 0.28Mb) Description: Type 2 diabetes mellitus is an increasingly prevalent presentation in Australian general practice, where most patients receive their preventive care and management.
25. Array http://feedproxy.google.com/~r... download (audio/mpeg, 4.29Mb) Description: Dr Anthony Fong talks to Dr Rachel Lee about how GPs can help maintain vision for patients with chronic eye disease. Anthony focuses on three common conditions – cataract, age related macular degeneration and glaucoma. He details the common risk factors, presentations and management strategies for each of these important conditions along with valuable information about primary and secondary prevention strategies that the GP can use and educate patients about.
26. Array http://feedproxy.google.com/~r... download (application/pdf, 0.37Mb) Description: Ocular disease in its early stages may be asymptomatic and insidious. Three of the leading causes of visual loss are cataract, age related macular degeneration and glaucoma.
27. Array http://feedproxy.google.com/~r... download (audio/mpeg, 3.72Mb) Description: Abbe Anderson, MBA, is CEO GPpartners, Lutweyche, Queensland. She discusses the role and training of Medical Assistants in primary care with Jenni Parsons. Medical assistants undertake a variety of administrative, reception and clinical duties in a primary care setting work under the supervision of doctors, nurses or practice managers. A 12 month TAFE course has been developed to train staff for this role. The clinical tasks that can be undertaken by medical assistants include wound dressings; venepuncture; and vision, hearing, height, weight and blood pressure checks. This role potentially provides flexibility of staffing in medical practices, with medical assistants undertaking administrative or clinical duties as required, freeing up nursing time for chronic disease management and more complex tasks. It also formalises and provides specific training for a role many medical receptionists have already partially undertaken in the primary care setting.
28. Array http://feedproxy.google.com/~r... download (application/pdf, 0.17Mb) Description: A new medical assistant training program has been developed as an innovative solution to the workforce pressures facing general practice in Australia.
29. Array http://feedproxy.google.com/~r... download (audio/mpeg, 5.60Mb) Description: Dr Anna Ralph, MBBS, MPH, DTM&H, FRACP, is an infectious diseases physician and PhD scholar untertaking research in tuberculosis. She discusses whats new in diagnosis and management of the very old disease of TB with Dr Jenni Parsons. Despite lower incidence of TB in Australia compared to other places in the world, TB remains a significant problem in a number of at risk groups including migrants from sub Saharan Africa, India, Vietnam, the Phillipines, China and Indonesia; patients with HIV; and Indigenous Australians. While newer diagnostic tests (interferon gamma release assays) are available, they have some limitations and in Australia sputum microscopic examination and cuture remains the main method of diagnosis in symptomatic individuals. Developments in pharmacotherapy include a metronidazole related antibiotic and agents targeting MTB genes. However, the standard first line treatment remains 6 months of rifampicin, isoniazid plus pyrazinamide and ethambutol for the first 2 months. In Australia, patients with TB are managed in specialty treatment units, the GP has an important roole in avoiding diagnostic delay, infection control, avoiding drug interactions (particularly with rifampicin), nutrition, smoking cessation, psychological support and encouraging adherence to therapy.
30. Array http://feedproxy.google.com/~r... download (audio/mpeg, 7.13Mb) Description: David Williams is a neurologist and associate professor of neurology at the Alfred Hospital in melbourne, Victoria. In this podcast, he talks to Dr Kathryn O'Connor about what GPs need to know about how to assess, investigate and treat patients who present with tremor.
31. Array http://feedproxy.google.com/~r... download (application/pdf, 0.20Mb) Description: Tremor is the most common movement disorder in the community and is defined as a rhythmic oscillatory movement of a body part. Classification of tremors is helpful for accurate diagnosis, prognosis and treatment. Most tremors can be separated according to the state in which they occur, that is, during rest or action. Other clinical features, including frequency, amplitude and associated neurological signs, further define tremor.
32. Array http://feedproxy.google.com/~r... download (audio/mpeg, 3.80Mb) Description: Justin Denholm, BMed MBioethics, is a research registrar, Victorian infectious Diseases Service, Royal Melbourne Hospital. He discusses the current issues in long term management of patients living with HIV with Jenni Parsons. Patients with HIV treated with combination antiviral therapy (cART) now often have rapid and sustained control of HIV viraemia (often to undetectable levels) and a sustained increase in CD4+ T-cell counts. This has resulted in decreased opportunistic infections and increased longevity.
33. Array http://feedproxy.google.com/~r... download (application/pdf, 0.24Mb) Description: Advances in the treatment of human immunodeficiency virus (HIV) have resulted in sustained improvements in the general health and longevity of people living with the virus. Primary care continues to be predominantly delivered by high caseload general practitioners and specialists, but GPs with limited HIV experience are increasingly likely to have contact with HIV positive patients through shared care arrangements.
34. Array http://feedproxy.google.com/~r... download (application/pdf, 0.28Mb) Description: Australia has among the world’s lowest rates of tuberculosis (TB). However, it remains a leading global cause of morbidity and mortality. In Australia, TB remains more common in Indigenous than non-Indigenous Australians, and rates are rising among migrants, reflecting changing immigration patterns and rising rates in their homelands.
35. Array http://feedproxy.google.com/~r... download (audio/mpeg, 2.91Mb) Description: Dr Fiona Millard, MBChB, FRACGP, MGP is an adjunct senior lecturer in Aged Care at James Cook University. She discusses research she has published in August 2009 AFP on what patients with dementia and their carers required from primary care providers, and the knowledge, attitudes and beliefs of health providers about dementia. Important themes from patients and carers include the need for timely investigation of symptoms, early and accurate diagnosis , explanation and support in the home. Up to 35% of GPs in the postal survey component said they preferred not to look after patients with dementia and about 15% of primary health providers indicated they thought early diagnosis may be harmful.
36. Array http://feedproxy.google.com/~r... download (application/pdf, 0.16Mb) Description: Health professionals have varying levels of knowledge about, and interest in, providing dementia services. This article compares patient experiences in dealing with dementia with the perceived role of health care providers in providing dementia care.
37. Array http://feedproxy.google.com/~r... download (audio/mpeg, 4.64Mb) Description: Dr Belinda Welsh, MBBS, MMed, FACD, is consultant dermatologist, St Vincent's Hospital Melbourne and Sunbury Dermatology and Skin Cancer Clinic, Sunbury. Belinda discusses the causes and clinical features of a variety of bullous skin rashes with Dr Jenni Parsons. Belinda discusses distinguishing features such as blister location, presence of mucosal involvement or whether the blisters are tense and intact (indicating dermal blistering) or fragile (indicating superficial blistering). Most presentations to GPs will be the result of infection, topical contact reaction, insect bites or drug reactions. However, if common conditions such as these are excluded, then often histology and immunofluoresence is required for diagnosis. Early referral to a dermatologist is recommended for Immunobullous disorders and serious non immunobullous diosorders such as porphyria cutanea tarda.
38. Array http://feedproxy.google.com/~r... download (application/pdf, 0.29Mb) Description: Blistering of the skin can be due to a number of diverse aetiologies. Pattern and distribution of blisters can be helpful in diagnosis but usually biopsy is required for histopathology and immunofluoresence to make an accurate diagnosis.
39. Array http://feedproxy.google.com/~r... download (audio/mpeg, 3.40Mb) Description: Dr Adriene Lee, BSc(Med), MBBS(Hons), FACD,is visiting dermatologist, St Vincent's Hospital and Monash Medical Centre, and Lecturer, Department of General Practice, Monash University, Victoria. She discusses the association between skin problems and systemic disease with Dr Jenni Parsons. Adrienne discusses skin conditions such as generalised pruritis, cutaneous vasculitis and erythema that may be an indicator of an underlying systemic condition; skin conditions that are much more rare but have an association with occult malignancy; and typical skin manifestations of connective tissue disorders.
40. Array http://feedproxy.google.com/~r... download (application/pdf, 0.35Mb) Description: Dermatologic complaints are a common reason for presentation to a general practitioner. In some cases, one needs to determine if the complaint may be a manifestation of a more serious underlying systemic disease.
41. Array http://feedproxy.google.com/~r... download (audio/mpeg, 4.05Mb) Description: Dr Steven Tomas, MBBS(Hons), MMed, FRACGP, CertDerm, CertSkinCanMed(SCSA), is a GP with a special interest in skin cancer managemen from Dubbo NSW. He discusses the features and management of subtypes of BCCs that have a more aggressive course with Dr Jenni Parsons.‘Infiltrative’ , ‘micronodular’ and ‘morphoeic’ BCCs can infiltrate widely and deeply with relatively little change in the overlying skin surface. Assessing the margins of the lesion histologically can bedifficult increases the chance of incomplete resection and recurrence. Recurrent or residual disease is more difficult to treat, and itself has higher recurrence and incomplete removal rates. These tumours require carefully planned, aggressive treatment to cure.
42. Array http://feedproxy.google.com/~r... download (application/pdf, 0.32Mb) Description: Basal cell carcinomas (BCCs) are common, and are regularly diagnosed and managed by Australian general practitioners.
43. Array http://feedproxy.google.com/~r... download (audio/mpeg, 2.54Mb) Description: Dr Ruth McNair is a GP and senior lecturer at the University of Melbourne. In this podcast she talks to Dr Kathryn O'Connor about what GPs need to know about lesbian and bisexual women's sexual health and the kinds of sexual health issues faced by this group of patients. In particular, it is important that GPs make their practice welcoming to lesbian and bisexual women. This can include providing signs and pamphlets in the waiting room, encouraging reception staff to use inclusive language and taking a non judgemental social and sexual history from patients. Ruth outlines important sexual health messages for lesbian and bisexual women including the need for pap smears and discussion of safer sex.
44. Array http://feedproxy.google.com/~r... download (application/pdf, 0.17Mb) Description: Lesbian and bisexual women have specific sexual health needs, including the need for information about transmission and prevention of sexually transmissible infections (STIs) between women, contraceptive and conception advice, and support regarding any abuse experiences.
45. Array http://feedproxy.google.com/~r... download (audio/mpeg, 5.87Mb) Description: Dr Catriona Bradshaw is a sexual health physician at Melbourne Sexual health Centre and NHMRC research fellow at Melbourne and Monash Universities. In this podcast she talks to Dr Kathryn O'Connor about what GPs need to know about Bacterial Vaginosis. Bacterial Vaginosis is the most common cause of abnormal discharge in women of reproductive age and yet the precise pathophysiology is contraversial. Research is continuing into the cause of this disease, whether or not it is a sexually transmissible infection (STI) and to establish effective evidence based treatments. BV is diagnosed with the Amsel or Nugent methods and treatment is with oral metronidazole or vaginal clindamycin with the aim to reduce symptoms and/or prevent complications.
46. Array http://feedproxy.google.com/~r... download (application/pdf, 0.23Mb) Description: Bacterial vaginosis is the commonest cause of abnormal vaginal discharge in women of reproductive age and is associated with serious pregnancy related sequelae and increased transmission of sexually transmissible infections, including HIV. The aetiology, pathology, microbiology and transmission of bacterial vaginosis remain poorly understood.
47. Array http://feedproxy.google.com/~r... download (audio/mpeg, 1.70Mb) Description: Professor Michael Berk discusses the relationship between sleep and depression and the clinical implications.
48. Array http://feedproxy.google.com/~r... download (application/pdf, 0.15Mb) Description: Sleep disorders are particularly common in the primary care setting, and are intimately interlinked with depression.
49. Array http://feedproxy.google.com/~r... download (audio/mpeg, 2.35Mb) Description: Dr Lyndal Trevena, author of ‘Cancer Screening – pros, cons, choice, and the patient’ in the April edition of AFP discusses some of the principles and controversies in cancer screening.
50. Array http://feedproxy.google.com/~r... download (application/pdf, 0.26Mb) Description: Cancer is a major cause of disability and death in Australia, with three government funded screening programs now in place nationally. As cancer screening tests are performed on healthy asymptomatic members within the community, one needs to consider whether the potential gains will outweigh possible harms. There are challenges for both practitioners and consumers in communicating about screening in practice.
51. Array http://feedproxy.google.com/~r... download (audio/mpeg, 4.85Mb) Description: David Forbes, Associate Professor, Australian Centre for Posttraumatic Mental Health, University of Melbourne, discusses the assessment and management of post traumatic stress syndrome (in particular the role of trauma focussed psychological therapy) with Dr Jenni Parsons. GPs can assist patients who have experienced trauma within the past 2 weeks by providing psychological first aid, and monitoring and assessment for the development of acute stress disorder and symptoms of PTSD. Trauma focused psychological treatment is the first line of treatment for PTSD, and in this interview David Forbes outlines what is involved in this specialised form of cognitive behavioural therapy.
52. Array http://feedproxy.google.com/~r... download (application/pdf, 0.31Mb) Description: Approximately 50–65% of Australians are exposed to a traumatic event during their lifetime. Approximately 250 000 Australians suffer from post-traumatic stress disorder (PTSD) at any given time, making it one of the most common anxiety disorders. In May 2007, the Australian guidelines for the treatment of adults with acute stress disorder and posttraumatic stress disorder was published. In order to facilitate translation of evidence regarding PTSD into busy clinical practice, and particularly for general practitioners, a more succinct version of the guidelines has been developed.
53. Array http://feedproxy.google.com/~r... download (audio/mpeg, 2.16Mb) Description: Dr Linda Foreman talks about the bowel cancer screening, including the National Bowel Cancer Screening Program. She discusses the role of the GP in the program and also reminds us to consider patients who may not be in the program.
54. Array http://feedproxy.google.com/~r... download (application/pdf, 0.30Mb) Description: Current Australian guidelines recommend regular screening with faecal occult blood tests (FOBT) in asymptomatic people over 50 years of age in order to reduce mortality from bowel cancer. After assessing the feasibility, acceptability and cost effectiveness of bowel cancer screening using FOBTs in an Australian setting, the Australian Government commenced the National Bowel Cancer Screening Program (NBCSP) in August 2006 among certain age groups.
55. Array http://feedproxy.google.com/~r... download (audio/mpeg, 2.86Mb) Description: Dr Nancy Huang, National Manager – Clinical Programs, Heart Foundation, talks about the article "Heart health: CHD management gaps in general practice". She discusses the concept of assessing absolute risk for all people over 45 years of age, and also the 3 key management gaps identified in CHD management relevant to general practice.
56. Array http://feedproxy.google.com/~r... download (application/pdf, 0.20Mb) Description: For many years, the Heart Foundation has been involved in the development of evidence based clinical practice guidelines for the management of cardiovascular diseases and conditions, including coronary heart disease (CHD). However, the production of guidelines does not ensure the uptake of evidence based recommendations in practice.
57. Array http://feedproxy.google.com/~r... download (audio/mpeg, 3.64Mb) Description: Kay Wilhelm, Conjoint Professor of Psychiatry, University of New South Wales, discusses the differences in presentations of depression between men and women with Dr Jenni Parsons. Men often display irritability and withdrawal in response to depression and are less likely than women to talk about their depression or how they feel. They tend to experience anxiety disorders less frequently than women. However, men’s greater risk taking and substance abuse have significant adverse physical and mental health outcomes. While men are usually wary about talking about their depression, they will discuss their feelings if provided with a safe environment in which to do so.Men are more generally accepting of ‘learning new tools to deal with stress’ than ‘support for emotional needs’, and men who are not psychologically literate will respond to psychoeducation that focuses on ‘need for change in lifestyle risk factors’. Men often do well with cognitive behavioural therapy (CBT) and problem solving techniques. Evidence about effects of depression on health, especially cardiac disease, can assist in gaining agreement for the use of antidepressants.
58. Array http://feedproxy.google.com/~r... download (application/pdf, 0.33Mb) Description: Kay Wilhelm, Conjoint Professor of Psychiatry, University of New South Wales, discusses the differences in presentations of depression between men and women with Dr Jenni Parsons. Men often display irritability and withdrawal in response to depression and are less likely than women to talk about their depression or how they feel. They tend to experience anxiety disorders less frequently than women. However, men’s greater risk taking and substance abuse have significant adverse physical and mental health outcomes. While men are usually wary about talking about their depression, they will discuss their feelings if provided with a safe environment in which to do so.Men are more generally accepting of ‘learning new tools to deal with stress’ than ‘support for emotional needs’, and men who are not psychologically literate will respond to psychoeducation that focuses on ‘need for change in lifestyle risk factors’. Men often do well with cognitive behavioural therapy (CBT) and problem solving techniques. Evidence about effects of depression on health, especially cardiac disease, can assist in gaining agreement for the use of antidepressants.
59. Array http://feedproxy.google.com/~r... download (audio/mpeg, 3.37Mb) Description: Darren Russell, Director of Sexual Health, Cairns Sexual health Service, discusses health issues of the newly single man with Dr Jenni Parsons. For men who are newly single there are a range of health issues that may arise including sexual health, alcohol and drug use, stress and mood disorders. The spectrum of health concerns varies with the age of the man and his individual circumstances. Importantly, when a newly single man presents to a GP, it provides a window of opportunity to begin a dialogue on preventative health strategies.
60. Array http://feedproxy.google.com/~r... download (application/pdf, 0.20Mb) Description: Darren Russell, Director of Sexual Health, Cairns Sexual health Service, discusses health issues of the newly single man with Dr Jenni Parsons. For men who are newly single there are a range of health issues that may arise including sexual health, alcohol and drug use, stress and mood disorders. The spectrum of health concerns varies with the age of the man and his individual circumstances. Importantly, when a newly single man presents to a GP, it provides a window of opportunity to begin a dialogue on preventative health strategies.
61. Array http://feedproxy.google.com/~r... download (audio/mpeg, 2.53Mb) Description: Edith Weisberg, Director of Research, Sydney Centre for Reproductive Health Research, Family planning New South Wales, discusses research into young women’s attitudes to and uptake of HPV vaccination with Dr Jenni Parsons. Two hundred and ninety-four women aged 15–26 years attending Family Planning NSW clinics completed the a questionnaire. Over 70% of the women had visited a GP in the previous 6 months but 40% were unaware that they could obtain free vaccination through a GP. Women 26 years old and under are eligible for free catch up HPV vaccination in 2009 but must have their first vaccination by 30 June 2009. After the end of 2009 women wanting HPV vaccination will need to pay for them themselves at a cost of approximately $140 for each of the 3 doses. General practitioners should use opportunistic visits by young women and recall and reminder systems to encourage women 26 years and under to commence vaccination by 30th June 2009.
62. Array http://feedproxy.google.com/~r... download (application/pdf, 0.17Mb) Description: Edith Weisberg, Director of Research, Sydney Centre for Reproductive Health Research, Family planning New South Wales, discusses research into young women’s attitudes to and uptake of HPV vaccination with Dr Jenni Parsons. Two hundred and ninety-four women aged 15–26 years attending Family Planning NSW clinics completed the a questionnaire. Over 70% of the women had visited a GP in the previous 6 months but 40% were unaware that they could obtain free vaccination through a GP. Women 26 years old and under are eligible for free catch up HPV vaccination in 2009 but must have their first vaccination by 30 June 2009. After the end of 2009 women wanting HPV vaccination will need to pay for them themselves at a cost of approximately $140 for each of the 3 doses. General practitioners should use opportunistic visits by young women and recall and reminder systems to encourage women 26 years and under to commence vaccination by 30th June 2009.
63. Array http://feedproxy.google.com/~r... download (audio/mpeg, 4.49Mb) Description: Romano Fois, lecturer, Faculty of Pharmacy, University of Sydney, discusses benefits and risks of compounded medicines with Dr Jenni Parsons. There has been an increase in the prescribing and dispensing of individualised pharmacotherapy in the form of compounded medicines in recent years. These medicines are not may have important benefits to the patient but their use requires that the prescriber and pharmacist carefully assess the evidence regarding their use, weigh up the benefits and risks, provided detailed consumer information and report any adverse drug reactions.
64. Array http://feedproxy.google.com/~r... download (application/pdf, 0.21Mb) Description: Romano Fois, lecturer, Faculty of Pharmacy, University of Sydney, discusses benefits and risks of compounded medicines with Dr Jenni Parsons. There has been an increase in the prescribing and dispensing of individualised pharmacotherapy in the form of compounded medicines in recent years. These medicines are not may have important benefits to the patient but their use requires that the prescriber and pharmacist carefully assess the evidence regarding their use, weigh up the benefits and risks, provided detailed consumer information and report any adverse drug reactions.
65. Array http://feedproxy.google.com/~r... download (audio/mpeg, 4.93Mb) Description: Jane Tracy, Education Director, centre for Developmental Disability Health Victoria, discusses successful communication in consultations with patients with intellectual disabilities with Dr Jenni Parsons. Jane discusses the range of verbal and non verbal communication that is used by patients with intellectual disabilities, including augmentative and alternative communication (AACT) systems. The principles of successful communication are to interact directly with the patient, tailor language appropriately, support communicative efforts, provide clear explanations and utilise pictures and diagrams, obtain additional information as necessary from carers and other sources with the patients permission and allow adequate time for consultations.
66. Array http://feedproxy.google.com/~r... download (application/pdf, 0.29Mb) Description: Jane Tracy, Education Director, centre for Developmental Disability Health Victoria, discusses successful communication in consultations with patients with intellectual disabilities with Dr Jenni Parsons. Jane discusses the range of verbal and non verbal communication that is used by patients with intellectual disabilities, including augmentative and alternative communication (AACT) systems. The principles of successful communication are to interact directly with the patient, tailor language appropriately, support communicative efforts, provide clear explanations and utilise pictures and diagrams, obtain additional information as necessary from carers and other sources with the patients permission and allow adequate time for consultations.
67. Array http://feedproxy.google.com/~r... download (audio/mpeg, 1.77Mb) Description: Dr Aleeta Fejo talks about being an indigenous doctor, efforts to increase the number of indigenous doctors in Australia, and helping out Santa for disadvantaged indigenous children.
68. Array http://feedproxy.google.com/~r... download (application/pdf, 0.12Mb) Description: I thought that this story started when I was 28 years of age, but actually, it started before I was born. I am a Larrakia Traditional Owner, inherited from my father, and I am a Warramunga woman from my mother.
69. Array http://feedproxy.google.com/~r... download (audio/mpeg, 4.43Mb) Description: Dr Tricia Nagel talks about the successful use of a brief goal setting intervention in remote indigenous communities. You don't need special skills, client self-care is enhanced, and co-morbid disorders are addressed in an integrated way. And it can be used in a wide variety of settings.
70. Array http://feedproxy.google.com/~r... download (application/pdf, 0.33Mb) Description: Detection and treatment of mental illness in indigenous communities is often complicated by cross cultural difference, social complexity and comorbid disorders.
71. Array http://feedproxy.google.com/~r... download (audio/mpeg, 2.71Mb) Description: GP Dr Andrew Knight talks to Dr Kathryn O'Connor about his approach to assessment and management of case study "Serge" who presents saying "I've been bleeding from the bowels". Patient history is important and open questions are especially helpful in complex presentations. Serge has multiple problems including tiredness, constipation and rectal bleeding. Causes of tiredness are many and varied and basic pathology can help exclude an organic cause. Screening for a psychogenic cause is important and the BATHE framework can is a useful method. It is important to address the patient's main concern; in this case "Serge" is concerned about cancer. Excluding cancer in Serge allows the GP to move onto other management priorities including lifestyle issues, possible sleep apnoea, cardiovascular risk and further psychological assessment.
72. Array http://feedproxy.google.com/~r... download (application/pdf, 0.21Mb) Description: Much undifferentiated illness is seen in general practice. Patients with a vague feeling of general unwellness may have multiple unrelated problems, serious underlying pathology, definite but indefinable pathology, and/or illness of psychological origin.
73. Array http://feedproxy.google.com/~r... download (audio/mpeg, 2.84Mb) Description: GP Dr Louise Stone discusses assessment and management of osteoarthritis in General Practice with Dr Kathryn O'Connor. Patient history is important; especially duration and severity of pain. Alternative diagnoses should be considered and excluded. Education and patient self management are vital as the management of osteoarthritis happens mainly outside the consulting room. Treatment modalities include exercise, weight loss, topical and oral medications, appliances. Referral to a surgeon may be required to allow the patient to gather information about future treatment options. Oraganisations such as Arthritis Australia can play a key role.
74. Array http://feedproxy.google.com/~r... download (application/pdf, 0.22Mb) Description: Aches and pains are commonly seen in general practice and osteoarthritis may be an underlying cause. Chronic pain can be very distressing for patients and management may be challenging for the general practitioner. Osteoarthritis is a common cause of chronic pain and disability.
75. Array http://feedproxy.google.com/~r... download (audio/mpeg, 3.51Mb) Description: Dr Michael Harrison discusses pathology testing in the tired patient with Dr Kathryn O'Connor. International guidelines on pathology testing in the tired patient vary and all are consensus rather than evidence based. Dr Harrison discusses the incidence of tiredness, the pick up rate of serious disease for pathology testing in the tired patient and other important reasons for decisions about testing in the general practice setting. He explains that, despite the fact that best practice eludes definition, it is possible to be rational in our approach to this problem.
76. Array http://feedproxy.google.com/~r... download (application/pdf, 0.20Mb) Description: Pathology tests are often ordered by general practitioners to investigate patients with nonspecific complaints such as malaise and tiredness.
77. Array http://feedproxy.google.com/~r... download (audio/mpeg, 5.95Mb) Description: Nick Collins, a GP from Leumeah, New South Wales, discusses planning for pandemic flu and the checklists from his article in October AFP, ‘Plan your pandemic- a guide for GPs’ with Dr Jenni Parsons. The discussion focuses on the practical strategies general practices can employ to both prior to and during a flu pandemic. Although the process can seen daunting, simple starting points of good staff and patient education, maintaining good infection control practices, encouraging good ‘cough etiquette’ and improving practice triage procedures will make significant differences and will have benefits to the practice in managing other infections and local disasters and improving patient safety and care.
78. Array http://feedproxy.google.com/~r... download (application/pdf, 0.21Mb) Description: Influenza A virus has a range of subtypes characterised by the display of particular surface structures and is associated with significant symptoms and a tendency to cause epidemics and pandemics.
79. Array http://feedproxy.google.com/~r... download (audio/mpeg, 3.15Mb) Description: Dr Steven Rudolphy discusses straight forward ways for the busy GP to improve asthma management with Dr Jenny Presser. Although asthma mortality rates in Australia have declined, our 'report card' in asthma management still has basic areas that need improvement, such as medication use and smoking cessation. He also talks about tricky areas - making sure of the diagnosis, differentiating asthma from COPD and wheezing in infants.
80. Array http://feedproxy.google.com/~r... download (application/pdf, 0.20Mb) Description: Asthma mortality rates in Australia have declined over the past 20 years but are not low by international standards.
81. Array http://feedproxy.google.com/~r... download (audio/mpeg, 4.76Mb) Description: Associate Professor Geoffrey Mitchell talks with Dr Jenny Presser about the role of the GP at different stages in a patient's cancer journey. The good news is that Australian cancer survivorship is increasing. Part of the improvement in cancer care world-wide is related to the development of a multidisciplinary team approach. There will be increasing opportunities for GPs to be involved in cancer care in the future, and there are some exciting new resources being developed.
82. Array http://feedproxy.google.com/~r... download (application/pdf, 0.25Mb) Description: The incidence of cancer is rising, so the workload of managing cancer is increasing rapidly. Among the advances in cancer care are advances in coordination of care, with team care being a preferred method.
83. Array http://feedproxy.google.com/~r... download (audio/mpeg, 1.80Mb) Description: In the longer term over 70% of people who have had depression experience disease recurrence. Dr Cate Howell discusses with Dr Jenny Presser how to identify those most at risk of relapse and recurrence and how to work with patients to improve that risk and develop a relapse prevention plan.
84. Array http://feedproxy.google.com/~r... download (application/pdf, 0.22Mb) Description: Depression is a potentially recurring or chronic disorder. The provision of evidence based treatment and effective practice organisation is central to chronic disease management, and these principles can be applied to managing depression.
85. Array http://feedproxy.google.com/~r... download (audio/mpeg, 3.57Mb) Description: Mr Sean Mackay discusses with Dr Carolyn O'Shea surgical causes of upper abdominal pain and some of the investigations that can help to make the diagnosis of a surgical cause.
86. Array http://feedproxy.google.com/~r... download (application/pdf, 0.16Mb) Description: In Australia, abdominal pain is a common presenting complaint in the general practice setting. Identifying a surgical cause is important and warrants prompt specialist referral.
87. Array http://feedproxy.google.com/~r... download (audio/mpeg, 2.74Mb) Description: Associate Professor Paul Pavli talks to AFP audio about the importance of a good history and examination in rationally selecting investigations to assist in assessing upper abdominal pain.
88. Array http://feedproxy.google.com/~r... download (application/pdf, 0.20Mb) Description: Upper abdominal pain is a common problem with an extraordinary diversity of possible causes. Many patients have no structural disease, and making the correct diagnosis can be a challenge.
89. Array http://feedproxy.google.com/~r... download (audio/mpeg, 2.68Mb) Description: Alison Fogarty and Grant Blashki talk about the GreenClinic project and what effect it had on the practices involved.
90. Array http://feedproxy.google.com/~r... download (audio/mpeg, 1.08Mb) Description: Don Henry, ACF Executive Director, talks about the importance of projects such as the GreenClinic project.
91. Array http://feedproxy.google.com/~r... download (application/pdf, 0.15Mb) Description: GreenClinic was a pilot educational program developed by the Australian Conservation Foundation and Doctors for the Environment Australia.
92. Array http://feedproxy.google.com/~r... download (audio/mpeg, 5.02Mb) Description: Dr Jaycen Cruikshank discusses the assessment and management of ventricular tachycardia, supraventricular tachycardia, atrial fibrillation and bradycardia with Dr Kathryn O'Connor. Accurate ECG interpretation is vital and faxing an ECG to a cardiologist or tertiary emergency department can help. The unconscious patient will require rescuscitation as per the Australian Resuscitation Council guidelines and the conscious patient requires IV access, oxygen, continuous cardiac monitoring and definitive treatment depending on the rythmn disturbance.
93. Array http://feedproxy.google.com/~r... download (application/pdf, 0.52Mb) Description: Diagnosis of acute arrhythmias requires recognition and interpretation of important electrocardiogram (ECG) findings, and knowledge of Australian resuscitation guidelines.
94. Array http://feedproxy.google.com/~r... download (audio/mpeg, 5.79Mb) Description: Dr Kathryn Browning Carmo discusses the role of the GP in managing the neonate before transfer to a tertiary centre with Dr Kathryn O'Connor. Early phone contact with the local Neonatal Emergency Transport Service provides GPs with much needed support and allows initiation of retrieval. Priorities include keeping the infant warm, assessment and management of airway, breathing and circulation, basic investigations and fluid and antibiotic therapy as necessary. It is vital to prepare the family for the arrival of the retrieval team.
95. Array http://feedproxy.google.com/~r... download (application/pdf, 0.27Mb) Description: Rural general practitioners involved in obstetric service delivery may have occasion to support the sick or premature newborn requiring transfer. This should be achievable for short periods of time in most rural hospitals.
96. Array http://feedproxy.google.com/~r... download (audio/mpeg, 3.69Mb) Description: Anne Fraser, clinical psychologist from the State child Development Centre in Western Australia discusses oppositional defiant disorder (ODD) with Dr Jenni Parsons. The discussion centres around distinguishing ODD from normal preschool or adolescent behaviour, associations with other behavioural and psychological problems and management strategies.
97. Array http://feedproxy.google.com/~r... download (application/pdf, 0.20Mb) Description: Oppositional defiant disorder (ODD) is defined as a repetitive and persistent pattern of opposition, defiant, disobedient and disruptive behaviours toward authority figures persisting for at least 6 months.
98. Array http://feedproxy.google.com/~r... download (audio/mpeg, 3.67Mb) Description: Dr Jill Sewell discusses the underlying causes, assessment and management of school refusal with Dr Jenni Parsons. School refusal is a heterogeneous and multifactorial problem that may relate to separation anxiety, anxiety-depression, learning difficulties, bullying, family dysfunction or the child needing to 'protect' a parent in situations of family violence or parental mental health problems.
99. Array http://feedproxy.google.com/~r... download (application/pdf, 0.18Mb) Description: School refusal occurs in 1–5% of all school children and has major social, emotional and educational implications for the child.
100. Array http://feedproxy.google.com/~r... download (audio/mpeg, 3.48Mb) Description: Dr Michael Harari discusses practical tips to gain a child's confidence in medical consultations with Dr Jenni Parsons. The judicious use of silliness, without acting the fool, can set a child at ease and facilitate assessment, history taking and examination.
101. Array http://feedproxy.google.com/~r... download (application/pdf, 0.14Mb) Description: Engaging children in a clinical setting is kind to the child and their family, and is a useful clinical tool. Each of us will have our own way of getting through a child's fears and defences. Tomfoolery, distraction and imaginary play can lead to a rewarding clinical interaction.
102. Array http://feedproxy.google.com/~r... download (audio/mpeg, 4.09Mb) Description: Christopher Brown, consultant ENT surgeon, Melbourne Nasal and Sinus Clinic, discusses the management of chronic rhinosinusitis in adults with Dr Jenni Parsons. The discussion focuses on the practicalities of assessment, optimising medical management and surgical options for patients who have failed medical management.
103. Array http://feedproxy.google.com/~r... download (application/pdf, 0.19Mb) Description: Chronic rhinosinusitis (CRS) is a common condition in the community, with significant morbidity and financial implications.
104. Array http://feedproxy.google.com/~r... download (audio/mpeg, 5.05Mb) Description: Professor Robert Berkowitz discusses the management of ear, nose and throat problems in children with Dr Jenni Parsons. The focus is on when to refer to an otolaryngologist for recurrent otitis media, adenotonsillar disease, suppurative complications of common infections and nasal injuries.
105. Array http://feedproxy.google.com/~r... download (application/pdf, 0.18Mb) Description: This article provides a general approach in determining when to refer a child to an otolaryngologist.
106. Array http://feedproxy.google.com/~r... download (audio/mpeg, 4.26Mb) Description: Professor Stephen O'Leary discusses technological advances in treatment of hearing impairment including digital technology in hearing aids, cochlear implantation and the bone anchored hearing aid (BAHA).
107. Array http://feedproxy.google.com/~r... download (application/pdf, 0.25Mb) Description: The treatment of hearing impairment is rapidly evolving. Despite this, a significant number of adults with hearing impairment receive inadequate treatment or rehabilitation, resulting in functional impairment and social isolation.
108. Array http://feedproxy.google.com/~r... download (audio/mpeg, 4.97Mb) Description: Dr Meredith Makeham author of the series of articles in AFP on the Threats to Australian Patient Safety (TAPS) study discusses the TAPS study and some of the findings relating to errors, harm and avoidance of errors.
109. Array http://feedproxy.google.com/~r... download (application/pdf, 0.16Mb) Description: The Threats to Australian Patient Safety (TAPS) Study collected 648 anonymous reports about threats to patient safety from a representative random sample of Australian general practitioners.
110. Array http://feedproxy.google.com/~r... download (audio/mpeg, 4.88Mb) Description: Maintaining an INR in the therapeutic range is an important area of patient management and safety. Kate Hodge talks about a program and evaluation to assist in a rural region.
111. Array http://feedproxy.google.com/~r... download (application/pdf, 0.15Mb) Description: Oral anticoagulation management is difficult in rural settings because of reduced patient access to pathology testing and medical management.
112. Array http://feedproxy.google.com/~r... download (audio/mpeg, 2.93Mb) Description: Associate Professor Jo Douglass outlines issues for GPs and patients in diagnosing and managing food allergy in adults.
113. Array http://feedproxy.google.com/~r... download (application/pdf, 0.23Mb) Description: There is a marked increase in the prevalence of food allergies. Food allergy can cause fatal anaphylaxis and the victims are most often adolescents and young adults.
114. Array http://feedproxy.google.com/~r... download (audio/mpeg, 3.44Mb) Description: Dr Marnie Robinson talk to AFP audio about 2 of the April theme articles on Allergy. She discusses paediatric allergy, including allergy tests, and the latest in allergy prevention recommendations.
115. Array http://feedproxy.google.com/~r... download (application/pdf, 0.20Mb) Description: The prevalence of allergic disease has increased considerably in recent decades and Australia has one of the highest rates of allergic disease in the world.
116. Array http://feedproxy.google.com/~r... download (application/pdf, 0.20Mb) Description: Allergic diseases (asthma, atopic dermatitis, allergic rhinitis and food allergy) are the commonest chronic diseases of childhood.
117. Array http://feedproxy.google.com/~r... download (audio/mpeg, 3.25Mb) Description: Dr Karen McKertich discusses procedural and surgical treatments for urinary incontinence in women.
118. Array http://feedproxy.google.com/~r... download (application/pdf, 0.34Mb) Description: A range of surgical treatment options is available for women suffering from stress and urge urinary incontinence refractory to conservative and medical management.
119. Array http://feedproxy.google.com/~r... download (audio/mpeg, 2.81Mb) Description: Dr Karen McKertich discusses assessment of urinary incontinence in women.
120. Array http://feedproxy.google.com/~r... download (application/pdf, 0.26Mb) Description: The aims of assessing urinary incontinence in women are to define the diagnosis, exclude other pathology and guide management. Treatment can be initiated when urinary incontinence is categorised as stress, urge or mixed incontinence.
121. Array http://feedproxy.google.com/~r... download (audio/mpeg, 0.00Mb) Description: Dr Patricia Neumann discusses physiotherapy for urinary incontinence
122. Array http://feedproxy.google.com/~r... download (application/pdf, 0.17Mb) Description: International guidelines recommend treatment for urinary incontinence by a health professional such as a pelvic floor or continence physiotherapist with specialised training in the management of pelvic floor disorders.
123. Array http://feedproxy.google.com/~r... download (audio/mpeg, 3.04Mb) Description: Overweight and obese adolescents face significant problems with their physical and emotional health. Professor Kate Steinbeck outlines the GP’s role in advocating for these kids and helping them reach realistic goals.
124. Array http://feedproxy.google.com/~r... download (application/pdf, 0.20Mb) Description: The prevalence of overweight and obesity continues to increase in adolescents. Community level management is necessary as specialist services are limited.
125. Array http://feedproxy.google.com/~r... download (audio/mpeg, 2.41Mb) Description: Dr Melissa Kang has a special interest in the sexual health of young people. In this interview, she observes changing patterns in youth sexual activity and some basic principles of safe sexual behaviour.
126. Array http://feedproxy.google.com/~r... download (audio/mpeg, 2.59Mb) Description: In this podcast, Melissa Kang attempts to enlighten Steve Trumble on successful communication with young people about their sexuality and sexual risks.
127. Array http://feedproxy.google.com/~r... download (application/pdf, 0.31Mb) Description: Young Australian people aged 12–25 years are sexually active at a younger age and have more sexual partners compared to previous generations. Pregnancy and sexually transmitted infection (STI) rates are high in this age group. Sexual violence, discrimination against same sex attracted youth, and associated health risk behaviours such as alcohol and drug use are also important sexual health issues for adolescents.
128. Array http://feedproxy.google.com/~r... download (audio/mpeg, 3.10Mb) Description: Dr Graham Fleming is a GP in rural South Australia who saw a problem with youth suicide in his area and went ahead and fixed it. He talks about practical approaches to adolescent mental health.
129. Array http://feedproxy.google.com/~r... download (application/pdf, 0.29Mb) Description: About 15% of the adolescent population suffers a mental health problem. Although a large percentage of these adolescents present to their general practitioner at least once a year, often their mental health problems are not presented or are somatised. Unfortunately, without intervention many of these mental health problems progress into adulthood where they are often more difficult to solve.
130. Array http://feedproxy.google.com/~r... download (audio/mpeg, 2.08Mb) Description: Cardiac pacemakers have come a long way in the 50 years since the first model needed its batteries changed after 3 hours. Dr Geoff Toogood discusses the indications for cardiac pacing.
131. Array http://feedproxy.google.com/~r... download (application/pdf, 0.48Mb) Description: Since the first cardiac pacemaker was inserted in 1958 vast changes have occurred in both the technology of the devices and their indications.
132. Array http://feedproxy.google.com/~r... download (audio/mpeg, 2.64Mb) Description: Dr Peter Kistler talks with Steve Trumble in the first of three podcasts on the management of cardiac arrhythmias. This interview focuses on his article in the pharmacological treatment of supraventricular and ventricular tachycardias.
133. Array http://feedproxy.google.com/~r... download (application/pdf, 0.30Mb) Description: Cardiac arrhythmias may present with palpitations, chest pain, shortness of breath, dizziness and syncope. Diagnosis may be complicated by an inability to document the arrhythmia particularly when symptoms are infrequent and short lived.
134. Array http://feedproxy.google.com/~r... download (audio/mpeg, 2.59Mb) Description: Atrial fibrillation is becoming increasingly common, especially in older people. In this podcast, Dr Peter Kistler discusses the control of rate and rhythm in atrial fibrillation.
135. Array http://feedproxy.google.com/~r... download (application/pdf, 0.23Mb) Description: Atrial fibrillation affects a significant proportion of the Australian population, affecting approximately 5% of people over 65 years of age.
136. Array http://feedproxy.google.com/~r... download (audio/mpeg, 1.42Mb) Description: In the final of his three podcasts, Dr Peter Kistler looks at the use of cardiac catheters in the management of arrhythmias.
137. Array http://feedproxy.google.com/~r... download (application/pdf, 0.40Mb) Description: Pharmacological management of arrythmias is not curative, is sometimes difficult, and may be associated with significant morbidity.
138. Array http://feedproxy.google.com/~r... download (audio/mpeg, 3.59Mb) Description: Your first day in general practice can be a mixture of excitement and terror. Victorian registrar Dr Emily Walsh explains how she survived her first training term, and felt like a real doctor at last.
139. Array http://feedproxy.google.com/~r... download (application/pdf, 0.16Mb) Description: After trying a couple of other disciplines in medicine I have finally found the career that suits me. If you, like me, are interested in most things, enjoy meeting people and can’t stand the smell of the average hospital ward, then general practice may really appeal.
140. Array http://feedproxy.google.com/~r... download (audio/mpeg, 0.00Mb) Description: Malaria is more than an inconvenience for Australian travellers; it is a serious disease that kills and injures millions of people each year. Dr Trish Batchelor talks with Steve Trumble about appropriate prevention and prophylaxis.
141. Array http://feedproxy.google.com/~r... download (application/pdf, 0.25Mb) Description: Malaria remains endemic in over 100 countries worldwide. Travellers to these countries may be at risk of contracting disease. Assessing risk on an individual basis can be challenging.
142. Array http://feedproxy.google.com/~r... download (audio/mpeg, 2.31Mb) Description: Dr Tony Gherardin discusses the approach to the intending traveller. What do they need to know and what does their GP need to tell them?
143. Array http://feedproxy.google.com/~r... download (application/pdf, 0.28Mb) Description: Australians are great travellers and the need for travel health advice can be a common presentation in general practice. General practitioners should be an important source of accurate and up-to-date information and provide appropriate travel medicine services.
144. Array http://feedproxy.google.com/~r... download (audio/mpeg, 3.45Mb) Description: Many Australian travellers baulk at the idea of paying for vaccines before they set off on their great adventures. But, as Dr Sonny Lau explains to Steve Trumble, GPs can help even those on a tight budget to invest wisely in the right vaccines.
145. Array http://feedproxy.google.com/~r... download (application/pdf, 0.22Mb) Description: Immunisation is very cost effective. It provides high level immunity against a range of general and travel specific pathogens. There are more vaccines available as research and development of vaccines progresses. Some vaccines require multiple doses to induce long lasting protective immunity, and some will only induce protective immunity for a limited period of time.
146. Array http://feedproxy.google.com/~r... download (audio/mpeg, 3.13Mb) Description: Dr Louise Stone looks at what's going on with some of our most challenging patients: those who somatise their problems. Are we helping by proving to them that there's "nothing wrong" when there clearly is?
147. Array http://feedproxy.google.com/~r... download (application/pdf, 0.27Mb) Description: Somatising disorders are a common, complex and disabling cluster of disorders. Research suggests that general practitioners find this group of patients challenging. The disorders are complicated by the fact that doctors play a role in both their aetiology and maintenance. The interaction between the illness worry of the patient and the disease worry of the doctor can lead to escalating disability and the risk of iatrogenic disease.
148. Array http://feedproxy.google.com/~r... download (audio/mpeg, 3.09Mb) Description: Cognitive Behavioural Therapy is revolutionising the way GPs treat patients with anxiety and depression. Dr Sarah Edelman talks about what types of CBT work best in the general practice setting.
149. Array http://feedproxy.google.com/~r... download (application/pdf, 0.22Mb) Description: It is well established that some individuals have an inherent disposition toward experiencing anxiety more readily than others. These individuals are prone to high levels of autonomic arousal, exaggerated threat perception and dysfunctional coping strategies.
150. Array http://feedproxy.google.com/~r... download (audio/mpeg, 4.42Mb) Description: Medication has no place in the management of mild depression, and only a limited role in moderate depression. Severe depression usually requires drug treatment and Dr Steve Ellen discusses some golden rules for prescribing.
151. Array http://feedproxy.google.com/~r... download (application/pdf, 0.20Mb) Description: Depression and anxiety are common presentations in general practice and medications are one of the key treatment strategies.
152. Array http://feedproxy.google.com/~r... download (audio/mpeg, 2.64Mb) Description: GPs occupy a unique position in being able to help people who are going through major life events. Professor David Clarke talks about the various coping strategies people use, and how we can help them cope more effectively.
153. Array http://feedproxy.google.com/~r... download (application/pdf, 0.27Mb) Description: General practitioners often see patients who are struggling with a change in their life circumstances. When this change involves illness, the GP is well placed to provide support and practical assistance. However, research in this area has tended to concentrate on the patient who is overwhelmed and unable to cope, focusing on the negative consequences of anxiety and depression.
154. Array http://feedproxy.google.com/~r... download (audio/mpeg, 3.16Mb) Description: Postmenopausal bleeding is always a cause for concern. An obvious, benign cause could be obscuring a carcinoma. Gynaecological oncologist Dr Alison Brand talks to Steve Trumble about how GPs should respond.
155. Array http://feedproxy.google.com/~r... download (application/pdf, 0.18Mb) Description: Postmenopausal bleeding is a common complaint from women seen in general practice.
156. Array http://feedproxy.google.com/~r... download (audio/mpeg, 3.43Mb) Description: Why do we do routine clinical breast and pelvic examinations in asymptomatic women? Is there any evidence that it increases the detection of breast or gynaecological malignancies? Associate Professor Jill Thistlethwaite and Dr Rebecca Stewart used an RACGP Silagy Scholarship to find out.
157. Array http://feedproxy.google.com/~r... download (application/pdf, 0.30Mb) Description: Clinical breast examination (CBE) is often offered as a component of the well woman check or carried out at the request of an asymptomatic woman. In these cases the examination is a screening procedure, as opposed to a diagnostic CBE in a symptomatic woman.
158. Array http://feedproxy.google.com/~r... download (audio/mpeg, 3.98Mb) Description: The launch of Australia's new vaccine for preventing certain strains of Human Papilloma Virus holds great promise in reducing the incidence of cervical cancer. But do we run the risk of missing tumors by slackening off on cervical cytology screening? Dr Stella Heley provides an update on Pap tests in this brave new world.
159. Array http://feedproxy.google.com/~r... download (application/pdf, 0.23Mb) Description: 2006 was an eventful year in the area of screening to prevent cervical cancer. New screening guidelines were introduced nationally in July, and in November the Australian Government agreed to fund one of the human papillomavirus (HPV) vaccines, Gardasil, under the National Immunisation Program.
160. Array http://feedproxy.google.com/~r... download (audio/mpeg, 2.28Mb) Description: Ovarian cancer is difficult to diagnose and hence it is often not detected before it is well advanced. Associate Professor Margaret Davey talks about some of the patient factors that should raise a GP's index of suspicion.
161. Array http://feedproxy.google.com/~r... download (application/pdf, 0.16Mb) Description: Epithelial ovarian cancer presents most often as late stage disease due to a lack of effective screening tests and vagueness of symptoms.
162. Array http://feedproxy.google.com/~r... download (audio/mpeg, 2.32Mb) Description: Work related upper limb disorders are common, expensive and difficult to treat. Rheumatologist and occupational physician Dr Michael Shanahan talks to Steve Trumble about effective management approaches, and answers the question: 'where has all the RSI gone?'.
163. Array http://feedproxy.google.com/~r... download (application/pdf, 0.20Mb) Description: Work related upper limb disorders (WRULDs) are among the most common workers' compensation claims. Their management is a challenge for medical practitioners for a range of reasons.
164. Array http://feedproxy.google.com/~r... download (audio/mpeg, 3.62Mb) Description: Dr Berny Trifiletti shares her acronym for helping injured workers get back on the job.
165. Array http://feedproxy.google.com/~r... download (application/pdf, 0.29Mb) Description: Achieving best outcomes in occupational injury management requires an emphasis upon identifying and managing those factors which – in addition to the medical condition – lead to progression to chronicity. The most studied common musculoskeletal workplace injury is low back pain.
166. Array http://feedproxy.google.com/~r... download (audio/mpeg, 2.70Mb) Description: Dr Peter Cotton is an organisational psychologist who believes that the "morale" in a workplace - and in the workers - plays a very significant part in determining health outcomes. In this interview he explains how two workers confronted with the same injury may respond differently depending on their emotional resilience.
167. Array http://feedproxy.google.com/~r... download (application/pdf, 0.23Mb) Description: Although most injured workers return to work with minimal intervention, approximately 20% show levels of distress and disability beyond that expected for the injury. The level of morale in a workplace seems to play a major role in this.
168. Array http://feedproxy.google.com/~r... download (audio/mpeg, 1.89Mb) Description: The management of acute low back pain is quite a challenging problem in general practice, especially when it is work-related and there are other issues at play. Dr John Low is an occupational physician from Subiaco, WA. He discusses the modern approach to getting back-injured workers back to work.
169. Array http://feedproxy.google.com/~r... download (application/pdf, 0.30Mb) Description: Back problems are the seventh most common reason for seeking care in general practice in Australia. Despite medical advances, chronic disability from back pain is a major contributor to the burden of disease in society today.
170. Array http://feedproxy.google.com/~r... download (audio/mpeg, 2.11Mb) Description: Endometriosis is a difficult condition to diagnose clinically; it also has major consequences for women in terms of pain, disablement and possible infertility. Dr David O'Callaghan gives Steve Trumble an update.
171. Array http://feedproxy.google.com/~r... download (application/pdf, 0.22Mb) Description: Endometriosis is one of the major causes of pelvic pain and subfertility in women.
172. Array http://feedproxy.google.com/~r... download (audio/mpeg, 1.59Mb) Description: Dr Jane Fischer talks about palliation of symptoms other than pain (including dyspnoea, nausea, constipation, and depression) in people with cancer and other diseases.
173. Array http://feedproxy.google.com/~r... download (application/pdf, 0.16Mb) Description: Symptoms other than pain are a heavy burden for patients with either malignant or progressive nonmalignant disease and significantly reduce quality of life.
174. Array http://feedproxy.google.com/~r... download (audio/mpeg, 1.24Mb) Description: Professor Patsy Yates discusses three of the most challenging areas of palliative care: when children are dying, when older people need decisions made, and when an Indigenous Australian is in need of palliation.
175. Array http://feedproxy.google.com/~r... download (application/pdf, 0.29Mb) Description: Ensuring access for all Australians to high quality palliative care requires an understanding of special considerations for specific populations, including children, older persons, and Indigenous Australians.
176. Array http://feedproxy.google.com/~r... download (audio/mpeg, 1.25Mb) Description: Rick Kausman talks about successful strategies for helping people be their most healthy weight
177. Array http://feedproxy.google.com/~r... download (application/pdf, 0.18Mb) Description: Helping patients to achieve and maintain their most healthy weight is a common challenge. Giving a 'one size fits all' set of instructions to patients who are over their most healthy weight does not help.
178. Array http://feedproxy.google.com/~r... download (audio/mpeg, 2.90Mb) Description: Dr Roger Neighbour, visiting President of the RCGP, talks with Steve Trumble about general practice in the United Kingdom and how it differs from Australia.
179. Array http://feedproxy.google.com/~r... download (audio/mpeg, 2.49Mb) Description: Dr Roger Neighbour, visiting President of the RCGP, talks with Steve Trumble about one of the skills that lies at the core of being a general practitioner: "phronesis", or practical wisdom.
180. Array http://feedproxy.google.com/~r... download (audio/mpeg, 1.66Mb) Description: While we do have medical workforce problems in Australia, they are nothing compared to those confronted by developing countries. Dr Malcolm Moore is a GP in Albury NSW who has worked in Nepal teaching local doctors the art and science of general practice. He talks about what Australian GPs can do to assist countries such as Nepal.
181. Array http://feedproxy.google.com/~r... download (application/pdf, 0.18Mb) Description: Australia has a well developed system of general practice and can be proud of the quality of its generalists. In many developing countries however, the idea of a trained generalist is not well understood. The global situation creates many opportunities and challenges for Australian general practitioners.
182. Array http://feedproxy.google.com/~r... download (audio/mpeg, 3.58Mb) Description: Children can be challenging customers at the best of times and no more so than when you are trying to repair their wounds. Fellow in Paediatric Emergency Medicine, Dr Ronan O'Sullivan, discusses practical approaches to the wounded child.
183. Array http://feedproxy.google.com/~r... download (application/pdf, 0.18Mb) Description: Minor injuries in children are extremely common in the general practice setting.
184. Array http://feedproxy.google.com/~r... download (audio/mpeg, 2.97Mb) Description: Leg ulcers are a common and time consuming problem in general practice. Poorly managed, they can result in unnecessary amputation or even death. One of Australia's leading wound management consultants discusses the basic approach to assessment and management.
185. Array http://feedproxy.google.com/~r... download (application/pdf, 1.52Mb) Description: A leg ulcer is not a disease but the manifestation of an underlying problem that requires a clear diagnosis.
186. Array http://feedproxy.google.com/~r... download (audio/mpeg, 3.80Mb) Description: The choice of dressings when managing skin ulcers is important, but not more so than making a proper assessment of the patient, their ulcer and the environment in which they exist. Associate Professor Keryln Carville discusses the use of the T.I.M.E. acronym to help choose the right approach.
187. Array http://feedproxy.google.com/~r... download (application/pdf, 0.70Mb) Description: Wound management is more than the application of a dressing. It requires a comprehensive and informed approach to the assessment of the patient, their wound and their healing environment.
188. Array http://feedproxy.google.com/~r... download (audio/mpeg, 0.00Mb) Description: Adolescence is a difficult time for most teenagers, but when you have a chronic illness such as diabetes it can be really tough.
189. Array http://feedproxy.google.com/~r... download (application/pdf, 0.20Mb) Description: During adolescence major hormonal, neuro-maturational, emotional and psychosocial changes occur within a relatively short time interval. The additional burden of living with a chronic disease such as type 1 diabetes can further add to the potential for instability.
190. Array http://feedproxy.google.com/~r... download (audio/mpeg, 2.76Mb) Description: Careful foot assessment is an important part of GPs' comprehensive care of people with diabetes.
191. Array http://feedproxy.google.com/~r... download (application/pdf, 0.18Mb) Description: Diabetes has long been associated with increased risk of foot ulceration and lower extremity amputation.
192. Array http://feedproxy.google.com/~r... download (audio/mpeg, 2.46Mb) Description: Dr Jonathan Cohen presents a timely update on the pharmacotherapy of glycaemic control and other factors that modify cardiovascular risk for people with type 2 diabetes. Metformin is usually the first line, but what comes next?
193. Array http://feedproxy.google.com/~r... download (application/pdf, 0.16Mb) Description: Patients with diabetes have a high cardiovascular risk. In addition to achieving good glycaemic control, cardiovascular risk reduction is a vital component of management.
194. Array http://feedproxy.google.com/~r... download (audio/mpeg, 0.00Mb) Description: General practice is all about listening to our patients as they tell us the story of their health. Dr Chris Pearce discusses the impact that both computers and evidence-based medicine are having on our ability to practise in this patient centred manner. If we lose the patient's narrative, do we lose the plot?
195. Array http://feedproxy.google.com/~r... download (application/pdf, 0.19Mb) Description: The doctor-patient relationship is crucial to the practice of medicine and yet the rise of science in the 19th and 20th centuries shifted doctors’ focus away from the patient toward another entity: the disease. Slowly, the medical profession is rediscovering the importance of the doctor-patient relationship.