Vulnerable populations

Latest Issue: 2016

Podcasts

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December

Acute pulmonary oedema – Management in General Practice

Dr Baird discusses the syndrome of acute heart failure, and its possible clinical presentations. He briefly discussions precipitants and causes of cardiac failure, and the different types of cardiac failure, namely systolic versus diastolic heart failure. He discusses an approach to the assessment and management of acute pulmonary oedema, with a focus on general practice care. Dr Baird goes on to discuss post-acute care, in particular how GPs can optimise wellbeing and prognosis in chronic heart failure patients.

Duration: 21 minutes 7 seconds
File size: 5MB

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End stage heart failure patients – palliative care in general practice

Professor Davidson discusses the term palliative care, and how if is used in patients with chronic heart failure. She discusses the challenges involved in providing palliative care and advanced care planning to these patients, including challenges specific to general practice care and ensuring that cultural, psychological, social and spiritual needs are met along with medical needs. Professor Davidson goes on to discuss a few specific symptoms that can be seen in patients with chronic heart failure, and how these may be managed symptomatically.

Duration: 29 minutes 30 seconds
File size: 7MB

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November

Transient ischaemic attacks – assessment and management

Dr Elaine Leung discusses why transient ischaemic attacks are a trap for the unwary and provides information on the importance and diagnosis. She also covers issues around assessment and how GPs are well placed to provide the secondary prevention management

Duration: 12 minutes 16 seconds
File size: 3MB

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Small dose... big poison

Professor George Braitberg discusses issues his article ‘Small dose…big poison' which considers children and ingestions of medications and many items found in every household

Duration: 22 minutes 58 seconds
File size: 5MB

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Addison disease – diagnosis and initial management

Dr Aris Siafarikas discusses Addison Disease, which is a trap for the unwary as it is rare and can present in non specific, but very serious ways. He suggests some hints that may assist in considering the diagnosis and highlights important elements of early management

Duration: 8 minutes 47 seconds
File size: 2MB

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October

Aging and sexuality

Dr Lesley Yee, a sexual health physician, discusses issues in aging and sexuality. This includes the changes associated with aging and the varying impacts these may have. She also provides some practical ideas to assist in raising the topic and providing advice

Duration: 11 minutes 40 seconds
File size: 3MB

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End of life care – the importance of advance care planning

End of life care and advanced care planning is a very important topic that can be difficult to raise. Dr Susan Lee discusses how patients expect their doctor to raise the topic, suggestions about how to raise the topic and assist in the discussion and also some resources that may be helpful

Duration: 11 minutes 35 seconds
File size: 3MB

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Bones beyond 70 – insights into osteoporosis management in the elderly

Osteoporosis is a major health concern with an aging population. Professor Charles Inderjeeth discusses his research based on a clinical audit about the current assessment and management of osteoporosis in those aged 70 years or more which found areas that can be improved

Duration: 15 minutes 29 seconds
File size: 4MB

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Substance misuse – management in the older population

Professor Dan Lubman discusses issues in substance misuse in the older population, including frequency, harms, issues to consider in the older population and tips on assessment and management

Duration: 12 minutes 26 seconds
File size: 3MB

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September

Rheumatoid Arthritis

Dr Ngian discusses rheumatoid arthritis, a chronic disease which is known to cause significant irreversible joint damage and disability if the so-called 'window of opportunity' for treatment is missed. Dr Ngian discusses the aetiology and typical clinical features of rheumatoid arthritis, and the investigations required if this type of arthritis is suspected, to ensure early recognition and referral. She uses the RACGP recently-published <em>Guidelines for the diagnosis and management of early rhuematoid arthritis</em> to discuss treatment options, and how to monitor patients on disease-modifying anti-rheumatic drugs and biologic agents

Duration: 16 minutes 32 seconds
File size: 4MB

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August

Opioid dependence – Management in general practice

Dr Matthew Frei discusses the management of opioid dependence using opioid pharmacotherapy, as part of a comprehensive chronic illness management strategy. Dr Frei discusses the risks and benefits of opioid pharmacotherapy and how it works. He also discusses how to assess and manage appropriate opioid-dependent patients, including the different opioid pharmacotherapy formulations available in Australia. He goes on to discuss other possible treatment options, including drug withdrawal. Finally, Dr Frei explains how GPs can become a trained opioid prescriber and how to get more information.

Duration: 22 minutes 2 seconds
File size: 5MB

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Party drugs – Use and harm reduction

Dr Matthew Frei talks about the risks associated with the use of the so-called ‘party drugs', and discusses a useful approach to general practitioner assessment and management of patients who may be using party drugs

Duration: 14 minutes 58 seconds
File size: 3MB

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Cannabis and psychosis and affective disorders

Professor Dan Lubman talks about cannabis use; the complex pharmalogy that underlies its the physical and psychosocial effects; and the links between cannabis and psychosis and affective disorders. He discusses the importance of adopting a a non judgemental approach to engage the patient, assess substance abuse and psychological comorbidity and minimise harm from cannabis use. Motivational interviewing techniques can assist the patient in making links between their cannabis use and mood and psychosocial difficulties

Duration: 14 minutes
File size: 3MB

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July

Pulmonary embolism

Dr Simon McRae discusses key issues in the diagnosis and management of pulmonary embolism, particularly considering the general practice setting

Duration: 14 minutes 45 seconds
File size: 3MB

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May

Epicentre of Influenza: The primary care experience in Melbourne, Victoria

Dr Jenny Bocquet talks about her qualitative research project exploring the early experience of selected frontline general practices in managing the 2009 H1N1 influenza outbreak. Dr Bocquet discusses the context of why she decided to perform this study, how her research was carried out, and the type of general practices involved. She discusses her how the general practices fared, including the strategies they used to manage, and whether they coped or were supported by government services. Dr Bocquet goes on to discuss how we can approach things differently in future flu seasons, and where we go from here to ensure greater preparation and support from government health services.

Duration: 21 minutes 13 seconds
File size: 5MB

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Meningococcal sepsis, croup, and minor head injuries in children

Dr Mike Starr talks about three childhood emergency presentations: meningococcal sepsis, croup, and minor head injuries, all of which are of significant importance in general practice. For each presentation, Dr Starr discusses which children are at risk, possible presentations, what to watch out for in history and examination, necessary investigations, and important management considerations in a general practice and a hospital setting.

Duration: 21 minutes 51 seconds
File size: 5MB

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Emergency Management of Type 1 Diabetes in Children

Dr Aris Siafarikas talks about how to approach the assessment and management of a child presenting in diabetic ketoacidosis due to Type 1 diabetes. Dr Siafarikas discusses diabetic ketoacidosis, including how children might present, which Type 1 diabetic patients are prone to developing DKA, and how general practitioners can diagnose a patient presenting in DKA. Dr Siafarikas then goes on to explore the appropriate management of a patient in DKA, including resuscitation, monitoring, rehydration and electrolyte replacement, insulin therapy, and managing recovery and follow-up. He also discusses the most important complication of severe DKA, that being cerebral oedema.

Duration: 10 minutes 33 seconds
File size: 2MB

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April

Compassionate listening - Managing psychological trauma in refugees

Dr Joanne Gardiner talks about compassionate listening and managing psychological trauma in refugees. Dr Gardiner stresses the importance of good rapport, taking time and addressing patient's concerns. She discusses the important intersection between physical and psychological trauma and the need for GPs to address both aspects. She provides helpful tips on how to sensitively ask about and deal with disclosures of trauma. Dr Gardiner discusses the three different phases of managing trauma and the importance of self-care for GPs working in this area

Duration: 21 minutes 52 seconds
File size: 5MB

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Mental health - Cultural competence

Dr John Furler talks about mental health and cultural competence. Dr Furler discusses concepts of depression and anxiety and why cultural and socioeconomic factors are important in mental health work in general practice. He stresses the need to have a flexible approach to this area rather than overly generalising about how different cultural groups may present. Dr Furler discusses the important influence that interpreters can have on consultations and how GPs can go about negotiating a shared understanding with their patients.

Duration: 13 minutes 38 seconds
File size: 3MB

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The importance of culture and ethnicity in end of life care

Associate professor Katherine Clark talks about the importance of culture and ethnicity in end of life care. Associate Prof Clark discusses the importance of recognising each patient and family as unique and sensitively asking them what is important to them and what sort of care and support they need. Rather than providing a checklist of different beliefs and practices around death, this podcast and the accompanying article explain how to sensitively approach death and dying with different groups. Important and relevant to any GP involved in palliative care for patients of any cultural group, the podcast and article also touches on useful resources and the key role GPs have in improving access to palliative care services.

Duration: 15 minutes 39 seconds
File size: 4MB

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Using interpreter services

Associate Professor Christine Phillips talks about how GPs and practices can most effectively use interpreter services. Associate Professor Phillips outlines the excellent free interpreting services available in Australia and how and when to efficiently access these services. She provides excellent tips for clinicians working with interpreters, particularly around controlling the consultation and making use of the interpreting time to enhance the consultation. She dispels several common myths about interpreter use and talks about what to do when things don’t go well. As all GPs and primary care clinicians will need to use interpreters for at least a proportion of their practice this podcast and the accompanying article are an excellent reference and resource guide.

Duration: 18 minutes 26 seconds
File size: 4MB

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March

Flying and lung diseases

Dr Matthew Peters discusses issues around flying and lung diseases, including COPD, asthma and sleep apnoea

Duration: 10 minutes 46 seconds
File size: 2MB

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Investigating chronic lung conditions

Associate Professor Graham Simpson talks about the investigations that are appropriate in general practice for chronic lung conditions

Duration: 19 minutes 21 seconds
File size: 4MB

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COPD diagnosis and management

Dr Julia Walters discusses COPD diagnosis and management in general practice, including the important roles general practice can play now and in the future

Duration: 17 minutes 35 seconds
File size: 4MB

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January/February

The role of the sports and exercise medicine physician

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. Most have specific areas of expertise, listed in the 'Find a Sports Physician' section of the ACSP website (<a href="http://www.acsp.org.au" target="_blank" rel="nofollow">www.acsp.org.au</a>).

Duration: 11 minutes 48 seconds
File size: 3MB

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