Substance Use

Latest Issue: December 2016

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December

Indigenous doctors

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

Duration: 7 minutes 44 seconds
File size: 2MB

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Brief interventions work in indigenous mental health

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

Duration: 19 minutes 19 seconds
File size: 4MB

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November

Pathology testing in the tired patient: a rational approach

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

Duration: 15 minutes 19 seconds
File size: 4MB

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Aches and Pains and Osteoarthritis

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

Duration: 12 minutes 23 seconds
File size: 3MB

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I've been bleeding from the bowels

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

Duration: 11 minutes 49 seconds
File size: 3MB

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October

Pandemic influenza

Nick Collins discusses planning for pandemic flu 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.

Duration: 25 minutes 57 seconds
File size: 6MB

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September

Improving asthma care

Dr Steven Rudolphy discusses straight forward ways for the busy GP to improve asthma management with Dr Jenni Parsons. 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. The National Asthma Council's Asthma Managment Handbook is an excellent GP resource

Duration: 13 minutes 45 seconds
File size: 3MB

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Our changing role in cancer management

Associate Professor Geoffrey Mitchell talks with Dr Jenni Parsons 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

Duration: 20 minutes 46 seconds
File size: 5MB

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Relapse Prevention in Depression

In the longer term over 70% of people who have had depression experience disease recurrence. Dr Cate Howell discusses with Jenni Parsons 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

Duration: 7 minutes 52 seconds
File size: 2MB

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August

Upper abdominal pain from a surgical perspective

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

Duration: 15 minutes 33 seconds
File size: 4MB

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Assessing upper abdominal pain

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

Duration: 11 minutes 57 seconds
File size: 3MB

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The GreenClinic project

Alison Fogarty and Grant Blashki talk about the GreenClinic project and what effect it had on the practices involved

Duration: 11 minutes 41 seconds
File size: 3MB

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Helping practices improve their environment

Don Henry, ACF Executive Director, talks about the importance of projects such as the GreenClinic project

Duration: 4 minutes 42 seconds
File size: 1MB

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July

Managing acute arrythmias

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

Duration: 21 minutes 54 seconds
File size: 5MB

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Neonatal care before transfer

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.

Duration: 25 minutes 17 seconds
File size: 6MB

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June

School refusal

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.

Duration: 16 minutes
File size: 4MB

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Consultations with children

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

Duration: 15 minutes 11 seconds
File size: 3MB

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Does this child have oppositional defiant disorder (ODD)?

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

Duration: 16 minutes 6 seconds
File size: 4MB

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May

Treating hearing impairment

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) with Dr Carolyn O'Shea.

Duration: 18 minutes 36 seconds
File size: 4MB

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ENT problems in children

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

Duration: 22 minutes 2 seconds
File size: 5MB

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Chronic Rhinosinusitis (CRC)

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

Duration: 17 minutes 52 seconds
File size: 4MB

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April

Issues in diagnosing and managing food allergy in adults

Associate Professor Jo Douglass outlines issues for GPs and patients in diagnosing and managing food allergy in adults

Duration: 12 minutes 46 seconds
File size: 3MB

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Paediatric allergy tests and allergy prevention recommendations

Dr Marnie Robinson discusses paediatric allergy, including allergy tests, and the latest in allergy prevention recommendations

Duration: 15 minutes 1 seconds
File size: 3MB

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Maintaining an INR in the therapeutic range

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

Duration: 12 minutes 46 seconds
File size: 5MB

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Threats to Australian Patient Safety (TAPS) study findings

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

Duration: 21 minutes 42 seconds
File size: 5MB

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March

Physiotherapy for urinary incontinence

In this podcast, Dr Patricia Neumann discusses physiotherapy for urinary incontinence

Duration: 19 minutes 28 seconds
File size: 4MB

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Assessment of urinary incontinence in women

In this podcast, Dr Karen McKertich, a Melbourne urologist, discusses the assessment of urinary incontinence in women

Duration: 12 minutes 15 seconds
File size: 3MB

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Procedural and surgical treatments for urinary incontinence

Dr Karen McKertich discusses procedural and surgical treatments for urinary incontinence in women

Duration: 14 minutes 12 seconds
File size: 3MB

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