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Laura Beaton chats with Paul Kubler, director of Rheumatology at Royal Brisbane and Women's hospital, about how to identify and manage antiphospholipid syndrome. They discuss the key presentations of APS, classification criteria and approaches to treatment. They also cover patients with catastrophic APS and asymptomatic people with persistent antiphospholipid antibodies. Read the full article by Paul and his co-authors in Australian Prescriber.
Welcome to FractureLine: the official weekly news feed from the Chest Wall Injury Society, where we will listen to all the bottom-line CWIS updates, shout-outs, fun facts, and weekly banter! This week's episode welcomes back the team, including SarahAnn Whitbeck, Dr. White, Dr. Bauman, & Dr. Mark Kryskow. We welcome first-time FractureLine guests and soon-to-be-members (hopefully): Drs. Cate Cameron (Jamieson Trauma Institute, Metro North Health, Royal Brisbane and Women's Hospital, Herston, QLD, Australia) & Fran Williamson (Trauma Service, Metro North Health, Royal Brisbane & Women's Hospital, Herston, QLD, Australia) to discuss their hot off-the-press article "Community opioid dispensing after rib fracture injuries: CODI study." Their study took place as a retrospective look at their community between 2014 and 2015 and has brought many interesting trends/findings to light. We also discussed proper etiquette for the gift-giving season and so much more! It is a holly-jolly time! We also continue with the Summit reflections, and this week, we will be joined by Dr. Ron Gross, CWIS stalwart and deservedly retired Luminary of the Chest Wall Injury Society!
Did you know there is a link between hormonal changes and seizures? New research is demonstrating a bi-directional relationship between hormones like estrogen and progesterone with electrical activity in the brain. We know there are vast differences in hormonal cycles between men and women, so why are standard epilepsy treatments not considering this? In this episode, we chatted with Dr. Lata Vadlamudi, an associate professor and senior staff specialist in neurology at the Royal Brisbane and Women's Hospital; She obtained her medical degree from the University of Queensland and completed physician training in the field of Neurology with further specialization in epilepsy in Melbourne, Sydney and the Mayo Clinic, USA. She obtained her PhD from the University of Melbourne with the thesis titled “The Genetics of Epilepsy: The Testimony of Twins." We discuss the neuroscience of epilepsy, how seizures are impacted by the menstrual cycle, birth control and menopause, tools for women with epilepsy, and what research needs to be done to improve clinical care. Authors: Elena Koning Email: thinktwicepodcast@outlook.com Instagram: @thinktwice_podcast LinkedIN: Think Twice Podcast Patreon: https://www.patreon.com/ThinkTwicePodcast Disclaimer: Think Twice is a podcast for general information and entertainment purposes only. The content discussed in the episodes does not reflect the views of the podcast committee members or any institution they are affiliated with. The use of the information presented in this podcast is at the user's own risk and is not intended to replace professional healthcare services.
Joel M. Dulhunty, MD, PhD, Royal Brisbane and Women's Hospital, and Jason A. Roberts, BPharm, PhD, University of Queensland Centre for Clinical Research, join JAMA Deputy Editor Preeti Malani, MD, MSJ, to discuss the BLING trial that assessed continuous vs intermittent β-lactam antibiotic infusions in patients with sepsis or septic shock. Related Content: Continuous vs Intermittent β-Lactam Antibiotic Infusions in Critically Ill Patients With Sepsis Prolonged vs Intermittent Infusions of β-Lactam Antibiotics in Adults With Sepsis or Septic Shock
Join this week's conversation with Dr Sam Bunzli which explores how health professionals can better understand and support people with osteoarthritis by moving beyond checklists and truly listening to their stories. We'll debunk common misconceptions about osteoarthritis, such as the belief that pain always means joint damage or that imaging is always necessary and provide evidence-based corrections.We'll also discuss the importance of culturally safe care and share resources for improving clinician communication. Finally, we'll look at how empowering communication and providing the right information, skills, and resources can help individuals manage their osteoarthritis effectively.Dr Sam Bunzli is a Senior Research Fellow in Physiotherapy who holds a conjoint position between the School of Health Sciences and Social Work at Griffith University and the Physiotherapy Department at the Royal Brisbane and Women's Hospital, Queensland Australia. In her program of osteoarthritis research, Dr Bunzli engages the voices of people with lived experience, their carers, and clinicians to advance person-centred communication and inform the design and implementation of interventions that meet their needs and preferences. Tune in for valuable insights and practical advice on living well with osteoarthritis.RESOURCESThe Osteoarthritis Health Professional Training ManualClinical Yarning: www.clinicalyarning.orgStaying Strong with Osteoarthritis: www.stayingstrongwitharthritis.org.auJournal of Orthopaedic and Sports Physiotherapy (JOSPT): Broken Machines or Active Bodies?Part 1. Ways of Talking About Health and Why It MattersPart 2: How People Talk About Osteoarthritis and Why Clinicians Need to Change the ConversationPart 3: Five Recommendations to Shift the Way Clinicians Communicate With People Who Are Seeking Care for OsteoarthritisCONNECT WITH USTwitter/X: @ProfDavidHunter @jointactionorgInstagram: @ProfDavidHunterEmail: hello@jointaction.info Hosted on Acast. See acast.com/privacy for more information.
Laura Beaton talks to Leonie Callaway, Obstetric and General Physician and Director of Research at the Royal Brisbane and Women's Hospital, about her article on the management of pre-existing diabetes in pregnancy. Leonie talks about maternal and fetal complications and the importance of high-quality preconception care, factors that can affect glucose control and the benefits of continuous glucose monitoring, and postpartum care. Read the full article by Leonie and her co-author Fiona Britten in Australia Prescriber.
In today's episode managing partner Tim Whybourne catches up with the entrepreneur, founder, and CEO of Audeara. In the episode, they cover everything from how James came from a career path as a doctor to the CEO of a listed business that creates and sells headphones for the hearing impaired. We talk about the highs and lows of being a founder and what it is like to run an ASX-listed business.Dr James Fielding is the Founder and CEO of Audeara, the Founder and Director of Robotics Engineering Research Laboratories, Founder and Director of Yumm! Confectionary and Founder and former Director of Field Orthopaedics. He worked in a range of fields before pursuing medicine, including at New York-based hedge fund Bay Harbour Capital and a prominent Hollywood production company. Dr Fielding was based at the Royal Brisbane and Women's Hospital before leaving full-time clinical medicine to focus on the founding and development of his start-up, Audeara. Audeara headphones have the capability to test and re-test the hearing of the wearer over the span of a lifetime. They tailor the sound to the needs of the individual to ensure all people, regardless of their hearing health can enjoy a world-class sound experience. Through his lead, Audera has also taken an active role in promoting awareness of hearing loss and related issues in the community.Disclaimer: The information in this podcast series is for general financial educational purposes only, should not be considered financial advice and is only intended for wholesale clients. That means the information does not consider your objectives, financial situation or needs. You should consider if the information is appropriate for you and your needs. You should always consult your trusted licensed professional adviser before making any investment decision.
Acknowledgement of Country// Headlines// Nathalie Farah of Disrupt Wars joined us live from the community picket that's been running weekly on Thursday and Friday mornings outside Heat Treatment Australia in Campbellfield. The picket has been established and maintained into its seventh week by members of the local Hume community in support of Palestine, who are protesting against HTA's role in heat-treating vital components required for Lockheed Martin's F-35 Joint Strike Fighter given their use by Israel in the genocide of Palestinians. Hume community members have committed to continued action outside HTA until it ends its contracts with weapons manufacturers profiteering off war and genocide.// Dr Sue Lewis, Acting President of the Victorian Forest Alliance, spoke with us about the recent announcement of the impending end of Vic Forests, which is set to wind up in mid-2024 after years of grassroots activism, official inquiries, legal battles and Parliamentary debate about the widespread harm that the entity has caused to Victoria's native forests. With the end of Vic Forests on the near horizon, we discussed the implications of its closure and what comes next for statewide native forest management. Respond to Kinglake Friends of the Forest's urgent call to action against Forest Fire Management Victoria's planned burns by sending an email (details below) or using the template here.// In the spirit of World Social Work Day, which falls on 20 March, we replayed an interview from June 2023 featuring Angelica Ojinnaka-Psillakis talking about the importance of investing in authentic youth voices, youth participation in mental health sectors, and advocacy. Angelica Ojinnaka- Psillakis is a youth development advocate, researcher, and speaker. She served as the 2022 Australian Youth Representative to the United Nations, and is involved in a number of projects and organisations.// Member of Whittlesea for Palestine Logan Balavijendran chats with us about the snap action on Saturday 23 March outside the office of Minister for Immigration, Citizenship and Multicultural Affairs Andrew Giles. The action has been prompted by Australia's decision to cancel the visas of Palestinians escaping genocide,some of which have occurred mid air, leaving several Palestinians stranded with no where to go. Australian families have paid thousands of dollars to bring their loved ones to safety, only to be left scared and worried about where their loved ones will go now. Logan resides in Whittlesea with his Palestinian partner and sons. He has a career spanning education and IT, and is committed to community-building to hold leaders accountable.// Ashleigh Buckett, Principal Solicitor at the National Justice Project, spoke with us about the coronial inquest into the 2016 death of Faysal Ishak Ahmed, a young Sudanese refugee, while he was detained on Manus Island in Australian immigration detention. The inquest, which ran across Monday and Tuesday this week, examined Faysal's access to medical treatment over several months prior to his death, and assessed the circumstances of his delayed medical evacuation to the Royal Brisbane and Women's Hospital, where he passed away. With the United Nations Subcommittee on the prevention of torture making the significant decision to suspend its visit to Australia in late 2022, citing obstructions to its work and a lack of co-operation, the inquest into Mr Ishak Ahmed's death may provide a rare window into the draconian operations of Australia's immigration detention regime.// The image used for this episode was taken by photographer Matt Hrkac. Go support his brilliant independent photojournalism here.// --- Kinglake Friends of the Forest Urgent Call to Action: Stop Planned Burns! We need your help to prevent an imminent and terribly ill-conceived planned burn that will impact greater gliders near Kinglake.We've been surveying for endangered greater gliders and hollow-bearing trees in a beautiful, varied patch of forest in Mt Robertson Rd, Kinglake. In one evening, 13 gliders were detected. Numerous habitat trees with good hollows suggest that many more live here, as well as providing crucial habitat for all sorts of hollow-dependent species. In addition, many habitat trees with fire scarring near their base from 2009 (Black Saturday) were recorded. These scarred trees become more liable to collapse with each subsequent fire. Forest Fire Management Vic has just announced they are going to burn this very patch of forest within the next few days.Here are just some of the reasons that burn HR-MUR-TLG-0008 is a bad idea.We are appalled to think of the impact that this unnecessary fire will have on the resident gliders, other wildlife and flora and on the older trees that survived the last fire because of:the immediate effects of the fire and smokeloss of food supply for gliders as a result of canopy scorchcollapse of den treesthe increase in fire risk in years to come because of the pulse of shrubs that will grow after the burnWe need to listen to the research that tells us that forests need to be protected from fire until they reach maturity when they are least flammable – estimated to be about 4 years from now in Kinglake.We can suppress fire using rapid detection technology available now. Thermal and heat sensing cameras can pick up fires kilometers away if installed in towers at optimum sight distance locations. We need to ensure we have trained remote area firefighters.What can you do?We (and the gliders) would love you to ring or write to any or all of the following, citing burn HR-MUR-TLG-0008.If you ring you'll want to keep it pretty short. You'll probably just speak to someone from admin so make sure you ask that they pass on your message.If you write, you could just copy and paste points 1-3, if you don't want to write your own. Maybe change the wording a bit if you can.The Hon. Steve Dimopoulos, Minister for Environment tel: 03 862 43101, email: reception.dimopoulos@ecodev.vic.gov.auTom Goldstraw, Senior Forest & Fire Management Officer – Fuel Management– Murrindindi District tel: 0439 130 146 thomas.goldstraw@delwp.vic.gov.auChris Hardman Chief Fire Officer | Lead Executive, Forest and Fire Operations Division, DEECA tel: 0419 563 413 chris.hardman@delwp.vic.gov.auThe Hon Jacinta Allan Premier of Victoria tel:0396515000 jacinta.allan@parliament.vic.gov.au
Where and how we care for preterm babies in South-East Queensland requires urgent review. Increased demand for service, improved survival rates, increased complexity of premature and sick newborns and a specialist nursing shortage has seen burgeoning pressure on large tertiary units, such as ours: The Grantley Stable Neonatal Unit (GSNU) at the Royal Brisbane and Women's Hospital (RBWH). Emerging evidence indicates that early discharge of physiologically stable, pre-term neonates is safe and cost-effective when appropriate in-home supports are in place (Brooten 1986; Cruz 1997; Collins et al, 2015). Given the comfort and psychological safety of the home environment, we anticipated enhanced parent-infant bonding. Health system level improvements, such as increased capacity within the Neonatal Unit would also result if we adopted similar models. In late 2021, the Women's and Newborn Service, Hospital in the Home project (NeoHOME and MatHOME) was successfully granted SEED funding from the Metro North Hospital and Health Service (MNHHS) Innovation Program. With their support and guidance, two arms of the project were developed (maternity and neonatal) and NeoHOME was born. The objectives of NeoHOME are: safe and effective care in the home for preterm neonates improved parental satisfaction, wellbeing and self-efficacy in addition to reduced financial burden, associated with long-term hospitalisation reduction in occupied bed days with anticipated improvements to capacity and staffing demands Clinical implementation commenced 4-months ago, and 61 neonates have been cared for in the home.
Liz and Jesse a joined by Stacey Deaville, Clinical Nurse Consultant with the Consultation Liaison Psychiatry team at Royal Brisbane and Women's Hospital. CL Psych provides mental health support to admitted patients in the acute health setting, who require additional supports related to their mental health risk or diagnosed illness during an admission. Stacey's Five Things: What is mental health? Importance of building a therapeutic relationship. De-escalation of emotions / aggression. Mental health assessment - mental state examination. When and how to refer to consultation liaison psychiatry team.
In this insightful podcast with Dr Matthew Peters, we chat about what a variety of skin removal surgery. We cover how long an operation can take, pain relief, how to manage scars and ask the big question about why his patients have such good looking belly buttons after surgery! Dr Matthew Peters is a Queensland-trained Plastic and Reconstructive surgeon, obtaining Fellowship of the Royal Australasian College of Surgeons after undertaking training in both General and Plastic surgery. He is the Director of Plastic and Reconstructive Surgery at the Royal Brisbane and Women's Hospital, a Senior Lecturer at the University of Queensland School of Medicine, and is a member of the Australian Society of Plastic Surgeons. If you are planning to get body contouring surgery, this podcast is a great listen.
Cash for young families, cut-price medication, as well as cheaper housing headlined the first Labor budget in almost a decade, but there is no tax relief for the vast majority of Australians as times get tough. Mothers who have lost babies will be placed on the same floor as maternity wards at the Royal Brisbane and Women's Hospital until at least next year, with Health Minister Yvette D'Ath blaming Covid for the “heartbreaking” practice. A high-profile Brisbane lawyer and a Gold Coast businessman used sham bank accounts to launder millions of dollars that were proceeds of crime, And.. The cost of diesel has hit record highs across the state, with prices reaching tops of 242.9c per litre throughout Brisbane as experts warn the worst could be yet to come.See omnystudio.com/listener for privacy information.
Monday 24th October 2022 Dietetics Digest The views discussed on the podcast are the views of the guest alone and not of another organisation.Is refeeding syndrome common? with Dr Kylie Matthews-Rensch APDDr Kylie Matthews-Rensch is an accredited practicing dietitian working at Royal Brisbane and Women's Hospital. Her research in refeeding syndrome has received national recognition and has impacted clinical practice guidelines across Queensland. TwitterIf you enjoyed the podcast, please can you support us by: Write a review on Apple Podcasts. Follow us on social media ( Twitter / Instagram ) Please share this podcast with a friend! This podcast is supported by an unrestricted ed...
Today in our sixth episode of Insights in Clinical Nutrition, we continue talking with special guest Emma Osland. Emma is an Advanced Accredited Practicing Dietitian currently based at the Royal Brisbane and Women's Hospital. Throughout her career to date, Emma has worked across a broad range of practice areas and is recognised for her expertise in the area of nutrition support. Emma has taken a lead role in developing AuSPEN's Adult Trace Element and Vitamin Guidelines for adults requiring parenteral nutrition and the AuSPEN Quality Framework for Home Parenteral Nutrition Provision. She is an active member of the AuSPEN HPN Model of Care working group, who are continuing to work towards laying the foundations required to establish a national model of care for HPN in Australia. Email: podcast@auspen.org.au Website: www.auspen.org.au/podcast References:1. Ambrose T, De Silva A, Naghibi M, Saunders J, Smith TR, Coleman RL, Stroud M. Refeeding risks in patients requiring intravenous nutrition support: Results of a two-centre, prospective, double-blind, randomised controlled trial. Clin Nutr ESPEN. 2021 Feb;41:143-152. doi: 10.1016/j.clnesp.2020.11.028. Epub 2021 Jan 8. PMID: 33487258.2. Blaauw R, Osland E, Sriram K, Ali A, Allard JP, Ball P, Chan LN, Jurewitsch B, Logan Coughlin K, Manzanares W, Menéndez AM, Mutiara R, Rosenfeld R, Sioson M, Visser J, Berger MM. Parenteral Provision of Micronutrients to Adult Patients: An Expert Consensus Paper. JPEN J Parenter Enteral Nutr. 2019 Mar;43 Suppl 1:S5-S23. doi: 10.1002/jpen.1525. PMID: 30812055.3. Dudrick SJ. History of parenteral nutrition. J Am Coll Nutr. 2009 Jun;28(3):243-51. doi: 10.1080/07315724.2009.10719778. PMID: 20150597.4. Ferrie, S. (2019). Does infusion time affect the retention of parenteral trace elements? British Journal of Nutrition, 122(1), 56-62. doi:10.1017/S0007114519000965.5. Klek S, Szczepanek K, Scislo L, Walewska E, Pietka M, Pisarska M, Pedziwiatr M. Intravenous lipid emulsions and liver function in adult chronic intestinal failure patients: results from a randomized clinical trial. Nutrition. 2018 Nov;55-56:45-50. doi: 10.1016/j.nut.2018.03.008. Epub 2018 Mar 22. PMID: 29960156.6. Osland EJ, Ali A, Isenring E, Ball P, Davis M, Gillanders L. Australasian Society for Parenteral and Enteral Nutrition guidelines for supplementation of trace elements during parenteral nutrition. Asia Pac J Clin Nutr. 2014;23(4):545-54. doi: 10.6133/apjcn.2014.23.4.21. PMID: 25516311.7. Osland EJ, Ali A, Nguyen T, Davis M, Gillanders L. Australasian society for parenteral and enteral nutrition (AuSPEN) adult vitamin guidelines for parenteral nutrition. Asia Pac J Clin Nutr. 2016;25(3):636-50. doi: 10.6133/apjcn.022016.05. PMID: 27440700.8. Osowska S, Kunecki M, Sobocki J, Tokarczyk J, Majewska K, Omidi M, Radkowski M, Fisk HL, Calder PC. Effect of changing the lipid component of home parenteral nutrition in adults. Clin Nutr. 2019 Jun;38(3):1355-1361. doi: 10.1016/j.clnu.2018.05.028. Epub 2018 Jun 6. PMID: 29907355.9. Rio A, Whelan K, Goff L, Reidlinger DP, Smeeton N. Occurrence of refeeding syndrome in adults started on artificial nutrition support: prospective cohort study. BMJ Open. 2013 Jan 11;3(1):e002173. doi: 10.1136/bmjopen-2012-002173. PMID: 23315514; PMCID: PMC3549252.10. Vinnars E, Wilmore D. Jonathan Roads Symposium Papers. History of parenteral nutrition. JPEN J Parenter Enteral Nutr. 2003 May-Jun;27(3):225-31. doi: 10.1177/0148607103027003225. PMID: 12757118.
Today in our fifth episode of Insights in Clinical Nutrition, we talk with special guest Emma Osland. Emma is an Advanced Accredited Practicing Dietitian currently based at the Royal Brisbane and Women's Hospital. Throughout her career to date, Emma has worked across a broad range of practice areas and is recognised for her expertise in the area of nutrition support. Emma has taken a lead role in developing AuSPEN's Adult Trace Element and Vitamin Guidelines for adults requiring parenteral nutrition and the AuSPEN Quality Framework for Home Parenteral Nutrition Provision. She is an active member of the AuSPEN HPN Model of Care working group, who are continuing to work towards laying the foundations required to establish a national model of care for HPN in Australia. Please note that the information shared in this podcast is for educational purposes only and does not constitute medical advice. Email: podcast@auspen.org.au Website: www.auspen.org.au/podcastReferences:1. Ambrose T, De Silva A, Naghibi M, Saunders J, Smith TR, Coleman RL, Stroud M. Refeeding risks in patients requiring intravenous nutrition support: Results of a two-centre, prospective, double-blind, randomised controlled trial. Clin Nutr ESPEN. 2021 Feb;41:143-152. doi: 10.1016/j.clnesp.2020.11.028. Epub 2021 Jan 8. PMID: 33487258. 2. Blaauw R, Osland E, Sriram K, Ali A, Allard JP, Ball P, Chan LN, Jurewitsch B, Logan Coughlin K, Manzanares W, Menéndez AM, Mutiara R, Rosenfeld R, Sioson M, Visser J, Berger MM. Parenteral Provision of Micronutrients to Adult Patients: An Expert Consensus Paper. JPEN J Parenter Enteral Nutr. 2019 Mar;43 Suppl 1:S5-S23. doi: 10.1002/jpen.1525. PMID: 30812055. 3. Dudrick SJ. History of parenteral nutrition. J Am Coll Nutr. 2009 Jun;28(3):243-51. doi: 10.1080/07315724.2009.10719778. PMID: 20150597. 4. Ferrie, S. (2019). Does infusion time affect the retention of parenteral trace elements? British Journal of Nutrition, 122(1), 56-62. doi:10.1017/S0007114519000965.. 5. Klek S, Szczepanek K, Scislo L, Walewska E, Pietka M, Pisarska M, Pedziwiatr M. Intravenous lipid emulsions and liver function in adult chronic intestinal failure patients: results from a randomized clinical trial. Nutrition. 2018 Nov;55-56:45-50. doi: 10.1016/j.nut.2018.03.008. Epub 2018 Mar 22. PMID: 29960156. 6. Osland EJ, Ali A, Isenring E, Ball P, Davis M, Gillanders L. Australasian Society for Parenteral and Enteral Nutrition guidelines for supplementation of trace elements during parenteral nutrition. Asia Pac J Clin Nutr. 2014;23(4):545-54. doi: 10.6133/apjcn.2014.23.4.21. PMID: 25516311 7. Osland EJ, Ali A, Nguyen T, Davis M, Gillanders L. Australasian society for parenteral and enteral nutrition (AuSPEN) adult vitamin guidelines for parenteral nutrition. Asia Pac J Clin Nutr. 2016;25(3):636-50. doi: 10.6133/apjcn.022016.05. PMID: 27440700.8. Osowska S, Kunecki M, Sobocki J, Tokarczyk J, Majewska K, Omidi M, Radkowski M, Fisk HL, Calder PC. Effect of changing the lipid component of home parenteral nutrition in adults. Clin Nutr. 2019 Jun;38(3):1355-1361. doi: 10.1016/j.clnu.2018.05.028. Epub 2018 Jun 6. PMID: 29907355.9. Rio A, Whelan K, Goff L, Reidlinger DP, Smeeton N. Occurrence of refeeding syndrome in adults started on artificial nutrition support: prospective cohort study. BMJ Open. 2013 Jan 11;3(1):e002173. doi: 10.1136/bmjopen-2012-002173. PMID: 23315514; PMCID: PMC3549252.10. Vinnars E, Wilmore D. Jonathan Roads Symposium Papers. History of parenteral nutrition. JPEN J Parenter Enteral Nutr. 2003 May-Jun;27(3):225-31. doi: 10.1177/0148607103027003225. PMID: 12757118.
Stav, Abby & Matt Catch Up - hit105 Brisbane - Stav Davidson, Abby Coleman & Matty Acton
Twenty years ago, Australia was rocked with a terrorist attack in Bali devastating countless lives. We spoke to the phenomenal surviver Polly Brooks (Miller) on how she defied the odds and found hope in the darkest of times. She spent her time recovering at the Royal Brisbane and Woman's Hospital Subscribe on LiSTNR: https://play.listnr.com/podcast/stav-abby-and-mattSee omnystudio.com/listener for privacy information.
This week on pod we have our most inspiring guest Swimmer Alexa Leary! Lex suffered life-changing brain injuries in a horrific cycling accident while training on the Sunshine Coast. She spent two weeks in an induced coma in the Intensive Care Unit (ICU) of Royal Brisbane and Women's Hospital (RBWH) and two months in the Neurosurgery Ward. She now is looking for Gold at the 2024 Paralympics in France! Get around Move For Lex!#moveforlex #afterpartypodcast #afa #afterpartypodcast #rugbypodcast #allblacks #nzrugby #ausrugby #rugbyunion #martyandmichael #rugbypodcast#sportspodcast #rugbypodcast Instagram: @afterpartypodcast_Instagram: @badboybaloney @moveforlex
This group presentation will provide a snapshot of how Metro North Hospital and Health Service is supporting the health and wellbeing of Aboriginal and Torres Strait Islander people in their care, as well as supporting staff to provide more culturally appropriate care. This includes: The Better Together Medication Access service which provides prescribed discharge medication to self-identifying Aboriginal and/or Torres Strait Islander people discharging from Metro North Health facilities at no cost to the patient, aiming to improve discharge medication access and therefore adherence, resulting in improved health outcomes. The Transforming Emergency Departments to Cultural Safety (TECS) project which is working to improve engagement with emergency and trauma care by creating a more culturally safe and welcoming environment for Indigenous people, particularly those who present with suicidal ideation or an acute mental health crisis. Incorporating a First Nations Senior Health Worker into the multidisciplinary team at the Royal Brisbane and Women's Hospital emergency department (ED), providing direct and immediate, culturally sensitive, clinical support to First Nations ED patients, and to role model culturally sensitive behaviours for ED clinicians.
Today's podcast is with the Neurosurgeon (yes, Neurosurgeon) Dr Alex Koefman . Alex has undertaken specialist training in neurosurgery throughout Australia, including The Canberra Hospital, the Royal Prince Alfred Hospital in Sydney, the Sir Charles Gairdner Hospital and Princess Margaret Hospital for Children in Perth, and the Princess Alexandra, Royal Brisbane, and Lady Cilento Children's Hospitals in Brisbane. During this time, Alex was trained and mentored by many of Australia's most senior subspecialty neurosurgeons and today we discuss his journey to Neurosurgery and what it's like opening up peoples' brains!
In this week's episode, SPA's Senior Advisor for Aged Care, Kym Torresi, speaks with Dr Anna Farrell, Director of Speech Pathology at Princess Alexandra Hospital, and Shana Taubert, senior speech pathologist at the Royal Brisbane and Women's Hospital. Anna and Shana share their extensive expertise in working with people with a progressive neurological disorder. Speech Pathology Australia acknowledges the Traditional Custodians of lands, seas and waters throughout Australia, and pay respect to Elders past, present and future. We recognise that the health and social and emotional wellbeing of Aboriginal and Torres Strait Islander peoples are grounded in continued connection to culture, country, language and community, and acknowledge that sovereignty was never ceded.
Liz Crowe is the Staff Wellbeing Consultant for the Royal Brisbane and Women's Hospital. In this special episode of the Queensland Clinical Senate podcast series, we talk to Liz about why it would be normal for clinicians to be feeling anxious in the midst of Queensland's surge of COVID-19 cases, and what we can all do to look after ourselves. She also offers great tips for leaders and managers to support their staff during the pandemic.
After three years, countless meetings and a global pandemic, Senate Chair Dr Alex Markwell's term will come to an end on 31 December 2021. Alex's leadership has been exceptional, steering the Senate through the COVID-19 pandemic, always ensuring frontline clinicians had the most up-to-date information available to support them in their roles. Alex represented clinicians at all levels of the state's COVID-19 health response, while also keeping her finger on the pulse working in fever clinics, vaccination clinics and in her clinical role as an emergency physician at the Royal Brisbane and Women's Hospital. Her desire to achieve the best health outcomes for Queenslanders was never far from her sights, keeping consumers involved every step of the way.We spoke with Alex about her time and achievements as Chair, her career as an emergency physician and what's next in her career.
The Ambassador program is focused on the proactive engagement of patients and visitors to improve the patient experience to prevent and/or reduce aggressive and disruptive behaviours. In collaboration with the Surgical and Perioperative Nursing leads, Royal Brisbane and Women's Hospital's Protective Services team, and QOVSU, it was established that the trial would be undertaken in the three most high-risk wards who regularly house complex surgical patients.
On July 17, 2021, life for Noosa triathlete Alexa Leary and her family changed in an instant.Lex suffered life-changing brain injuries in a horrific cycling accident while training on the Sunshine Coast. She spent two weeks in an induced coma in the Intensive Care Unit (ICU) of Royal Brisbane and Women's Hospital (RBWH) and two months in the Neurosurgery Ward.During this time Lex's sister Maddy started an incredible movement that has inspired the WORLD to get out there and start moving for those who can'tListen to this episode for gratitude, inspiration and to hear the story of Lex and her family.
Decisions regarding glycaemic control may not be simple as there are situations where you strive for tighter control or settle for less than satisfactory control There is real art in treating the elderly patient and ensuring the maintenance of quality of life without introducing drug adverse reactions New medications do give us better choices Host: Dr David Lim | Total time: 35 mins Guests: A/Prof Michael d'Emden, Endocrinologist; Director of Diabetes and Endocrinology, Royal Brisbane and Women's Hospital Register for our fortnightly FREE WEBCASTS Every second Tuesday | 7:00pm-9:00pm AEST Click here to register for the next one See omnystudio.com/listener for privacy information.
In this week's episode, the Good GP interviews vascular surgeon, Dr Samantha Peden on venous ulcers and chronic venous insufficiencies. We explore the prevalence in certain patients, presentations, the missed diagnoses and tips for differentiating venous and arterial ulcers. We also explore referrals and recommendations for GPs with patients presenting with possible venous disease, arterial disease and the management of venous ulcers, including dressing options. Dr Samantha Peden is a vascular surgeon at the Royal Brisbane, and Women's Hospital.
Liz Crowe spent 25 years as a social worker, predominantly in paediatric intensive care and critical care. During that time she developed a passion for clinician wellbeing and started researching how she could support her colleagues. Her passion recently became her profession and Liz now draws on her clinical experience and research in her new role as a staff wellbeing consultant, counsellor and coach in one of Queensland’s largest tertiary hospitals. In this interview, Liz shares some of her experiences, along with tips to help fill our tanks, feel less stressed and more engaged, particularly in the midst of a global pandemic.
What a truly insightful conversation with Dr. Christian Heim. It was fun to talk about music and about bulimia.Dr. Heim truly answers the question in such an elightening way about relapse, and how hobbies define you and can be a catalyst to moving from bulimia to a healthy identity connection.What is apparent is that Dr. Heim helps the listeners understand how bulimia is NOT shameful, that it is, as other of my guests have explained, a part of coping. Having said that, there is a way out and full recovery is possible.Listen to the wise words he shares as a consultant spychiatrist, psychotherapist who has had experience dealing with eating disorders... and his many kind and fun words...You can reach Dr. Heim at https://www.drchristianheim.comMore about Dr. Christian Heim:Dr. Heim PhD is an award-winning Psychiatrist, Music Professor and Churchill fellow. During his 20 years of continuing clinical practice he has heard the stories of 1000s of people, so he listens a lot. He was acting head of the Royal Brisbane and Women's hospital inpatient eating disorders unit. He gets lots of joy out of working as a consultant psychiatrist in psychotherapy. He speaks from a place of deep compassion and authority on Mental Health issues that are affecting us all in this new normal: anxiety, depression, addictions, trauma, suicide, personality issues and relationship breakdown. His latest book "The 7 types of Love: navigating love in a fractured world" has just been released! He lives in Australia on the beautiful Sunshine Coast with his wife Caroline and loves taking long walks on deserted Australian beaches and eating celery.#bulimia #bulimiarecovery #bulimiaover40 #midlifebulimia #bulimiaover50 #eatingdisorder #eatingdisorders #bullimiaddict #iamthatgal #bulimiacoach #bingepurge #bingeingandpurging #throwup #deceit #hide #lie #food #overeating #bleepbulimia #podcast #itunes #apple #buzzsprout #amazonmusic #alexa You can join my support group on FB at https://www.facebook.com/groups/bullimiaddictFind me on instagram @bullimiaddict and @bleepbulimiaAnd for a 10 year blog during my recovery go to https://www.bullimiaddict.comTo sign up as a guest on my podcast visit https://www.bleepbulimia.comYou can also visit us on FB at https://www.facebook.com/groups/bleepbulimiaNew Release Kindle or Signed Copy! How To Have Your Cake & Not Eat It All Too - A Guide To Adult Bulimia RecoveryBE A GUEST/FIND A GUEST Start for Free! PODMATCH is innovative, provides easy communication and dashboard scheduling! My pick of the month!Buzzsprout - Let's get your podcast launched! Start for FREEDisclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.Support the show
Emily Ragus is an Emergency Nurse who worked at the Royal Brisbane and Women's Hospital for 15 years and with LifeFlight Australia as a Retrieval Nurse before moving to New York City to study a Diploma of International Humanitarian Assistance at Fordham University.Emily is currently deployed to South East Asia as a Health Delegate for the International Committee of the Red Cross. Last year she was awarded the prestigious Sir John Monash Scholarship to study gender-based violence during humanitarian disasters.
Influenza outbreaks place a significant annual burden on the Australian healthcare system. There is well documented evidence that increasing rates of influenza vaccination, especially amongst high risk patients will decrease the number of confirmed cases of influenza, reduce hospital admissions, associated costs and death. Despite this, under usage of immunisation programs continues to be a significant public health concern with inadequate time to attend a venue for vaccination being identified as a significant contributor to less than ideal vaccination rates. The Royal Brisbane and Women's Hospital pharmacy service has input into ambulatory outpatient services, making it ideal for providing opportunistic vaccinations to patients in a hospital outpatient setting. The aim was to investigate the impact of such a service on increasing access for high-risk patients to receive their annual influenza vaccination. Learn more To watch Kim's interview, visit the Clinical Excellence Showcase website. For information about the project, visit their page on our Improvement Exchange. Please subscribe to ‘Clinical Excellence Showcase' wherever you digest your podcasts, rate and review on iTunes and follow us on social media: Facebook, Twitter and Instagram.
Funded by the New Technology Funding and Evaluation Program, the Royal Brisbane and Women's Hospital has been working to locally manufacture CAR-T cells. Patients' T-cells are modified to include a chimeric antigen receptor (CAR), which can directly target and kill cancer: a new era in cancer immunotherapy. Learn more To watch Glen's interview, visit the Clinical Excellence Showcase website. Please subscribe to ‘Clinical Excellence Showcase' wherever you digest your podcasts, rate and review on iTunes and follow us on social media: Facebook, Twitter and Instagram.
As the 8th anniversary of Queensland's historic apology in parliament for past forced adoption policies and practices nears, Jigsaw Qld's Forced Adoption Support Service (FASS) Team Leader, Andrea Lynch talks to Jo about two Queensland projects aimed at educating the public about the State's dark adoption history and memorialising it in hope that these policies and practices are never forgotten or repeated. They discuss the memorial plaque located in the foyer of the Royal Brisbane and Women's Hospital and the Without Our Consent - A Queensland Story digital memorial. This episode discusses adult themes and listener discretion is advised. For more information about these projects, go to www.jigsawqueensland.com/episode-notes.Do you have a story to tell? If so, we'd love to hear from you. Got to www.jigsawqueensland.com/adopt-perspective to fill in a Prospective Guest Form. Note: Adopt Perspective is listened to all over the world.
Welcome back for episode 87 of The Bodybuilding Dietitians Podcast! On this week's episode Tyarra and Jack interviewed Dr. Graham Radford-Smith. Graham is a gastroenterologist with extensive clinical (consultative and procedural) experience across a wide range of GI disorders. He specializes in the fields of Inflammatory Bowel Diseases (IBD – Crohn's disease, ulcerative colitis) and non- inflammatory gut disorders. Graham developed the Crohn's and Colitis centre at the Royal Brisbane and Women's Hospital (RBWH) together with Australia's first series of IBD specialist clinics and a Telehealth program for regional Queensland. He introduced IBD specialist nursing during this period. Graham is an honorary group leader at the QIMR Berghofer Medical Research Institute where he works with his team in the Gut Health research group, Associate Professor within the Faculty of Medicine, University of Queensland, Chair of the ANZ IBD consortium of clinicians, and Chair of Crohn's Colitis Cure (a charity supporting research and clinical practice for clients with IBD). In this episode Graham provided highly valuable insight into answering and discussing the following topics: - Factors that influence gut health - Factors that influence the gut microbiota and microbiome - Introduction to Crohn's disease and ulcerative colitis – the inflammatory bowel diseases - Differentiating IBD from functional GI disorders such as irritable bowel syndrome Thank you again for tuning into the podcast and we hope you enjoy! We would greatly appreciate if you would please subscribe to the channel, give us a rating, leave us a review and tell your friends about the podcast! The more people we can reach out to and help the better! Stay tuned for more podcasts released on a weekly basis! Integrated Gut Health: http://www.integratedguthealth.com/ Business Website: www.thebodybuildingdietitians.com Youtube Channel: www.youtube.com/channel/UC9Why7Cv…disable_polymer=1 Tyarra's Instagram: www.instagram.com/tyarranelson/?hl=en Jack's Instagram: www.instagram.com/jack.radfordsmith/?hl=en The Bodybuilding Dietitians Instagram: www.instagram.com/thebodybuildingdietitians/?hl=en VPA 15% off links: vpa.fit/tyarra vpa.fit/jack Sam The Border Collie's Instagram: www.instagram.com/sams_tales/?hl=en
John Barton is the CEO of MGD, a Brisbane based wealth management company. What struck me when we first met, many years ago, was his generosity in sharing his knowledge and his time. John is driven by an absolute focus on values, quality, teamwork and corporate citizenship, and while this is apparent in his work, it also comes across in his volunteer community work. He is currently the Chair of Business South Bank and sits on the board of the Royal Brisbane and Women's Hospital Foundation. He has almost 30 years experience in banking, financial services and wealth management roles, and, unsurprisingly, a strong focus on the charitable and not-for-profit sector as part of MGD's Philanthropic Advisory team. He is also fascinated by the area of behavioural economics – the study of emotions and psychology and how they influence real-world finance and investment decisions. Away from the office, John is a regular cyclist and is frequently seen riding his bike in and around Brisbane. He also enjoys golf and sharing a good cabernet. You can connect with John at www.mgdwealth.com.au and on LinkedIn or Twitter. You can listen to this episode via the link below, on Apple Podcasts or Spotify or via the podcast app on your smartphone. What John Barton and I talked about: We are social beings Sharing experiences and helping others where we can How we can thrive and find purpose in life Checking in on people during COVID-19 – who has been automatic and who has surprised you Natural positives of COVID-19 How we can manage our personal finances – what is the reality of where you are right now and where you may be in the months ahead Creating a personal budget of where income is coming from but also where the expenses are going to What are we spending money on in our personal lives? Marie Kondo your finances – “does this subscription bring me joy in my life?” Peter Cook – “everyone is dysfunctional with money” – how do we hasten slowly? Cycling, Zoom coffee and Zoom beer with friends Staying connected with your workforce Start with Why by Simon Sinek Seamless by Anders Sörman-Nilsson. You can connect with me on LinkedIn or Twitter or Instagram using the hashtag #thisconnectedlife and tagging me @melkettle. Mel Kettle is all about connection, communication and collaboration. She works with CEOs, leaders and teams to help them better communicate and collaborate (online AND offline) to achieve better relationships, revenue and results. Mel is a facilitator, trainer, speaker, author and mentor who provides practical advice that achieves results while having some fun! Download her latest whitepaper, The Social CEO – from invisible to influencer or order a signed copy of her book, The Social Association. To inquire about working with Mel, please email mel@melkettle.com or call her on 0404 600 889.
The world is battling with the COVID-19 pandemic. Dr Peter Thomas, Consultant Physiotherapist from Royal Brisbane and Women’s Hospital, Australia, and colleagues have produced a guideline called “Physiotherapy Management for COVID-19 in the Acute Hospital Setting: Recommendations to Guide Clinical Practice” which is due to be published imminently in the Journal of Physiotherapy. This podcast is a conversation between Dr Thomas and Dr Claire Nolan, PR Assembly web committee director and Senior Research Physiotherapist, Harefield Hospital, UK, on the content of the guideline. The link to the guideline will be shared once the guideline is available.
What many people don’t realize is the physiological impact that scars can have on their bodies — whether it's a minor scar from falling as a child, a high-school football injury, burn, or a C-section scar. While not every scar presents a problem, many do. If your body doesn’t break down scar tissue completely, it will often spread — triggering your body to compensate. Any kink, pull or restriction in one area can impact the rest of the body. If your movements are restricted, your muscles will be forced to compensate by working harder. Nerve entrapment can affect circulation and cause pain and discomfort. In this week's podcast episode, Marni will be speaking with Angela Thynne, Director of Scar Care, to learn more about Scarring treatments, causes and management. Angela is an occupational therapist with over 25 years’ experience in the management of scarring and oedema following traumatic injuries, burns and surgery. She has run her private practice, Scar Care, specialising in scarring and oedema for over 20 years, and has extensive experience in treating both adults and children with scarring and oedema. Her experience has been within both the private and public sectors, including clinical practice, research, teaching and training. She is a credentialed private practitioner to the Professor Stuart Pegg Adult Burns Centre at the Royal Brisbane and Women’s Hospital. Angela is a clinical lecturer in scar and oedema management at the School of Health and Rehabilitation Sciences at the University of Queensland and is the co-coordinator of the Burns Rehabilitation Course of the Australian and New Zealand Burn Association She is passionate about the prevention and treatment of traumatic and surgical scarring. She has committed her professional life and ongoing professional training to the minimisation and management of scarring. Learn more about Angela Thynne here: Website: https://www.scarcare.com.au/ LinkedIn: https://au.linkedin.com/in/angela-thynne Be sure to subscribe to the podcast! And follow us on Instagram @dermhealth.co or visit us online at https://www.dermhealth.co/ --- Send in a voice message: https://anchor.fm/dermhealthco/message
A/Prof John Atherton, Director of Cardiology, Royal Brisbane and Women’s Hospital, describes major new developments regarding the role of SGLTs in the prevention and management of heart failure in this podcast, findings that relate both to patients with and without T2D. He will describe the significance of the recently reported DAPA HF findings and their practical relevance to frontline health professionals.
Tranexamic acid is an old drug with a new purpose, and is increasingly found in the drug kits of prehospital providers. Dr Dan Bodnar, Deputy Medical Director of Queensland Ambulance Service, joins Todd on the podcast to discuss the uses, evidence base and administration of Tranexamic acid. Dan is a Brisbane based Emergency Physician. His work life between the Royal Brisbane and Women's Hospital, the Queensland Ambulance Service and the Queensland Children's Hospital.
Kaye Hooper is a specialist MS nurse of 25 years and has worked as the MS Nurse Consultant at the MS Clinic at the Royal Brisbane & Women’s Hospital. Prior to this, her nursing career saw her in the USA, West Africa and also East Africa. She is a founding Board member of the International Organisation of MS Nurses and founding president of MS Nurses Australasia. This podcast highlights the vital role that the MS nurses can play in your own journey with MS. They provide invaluable support and specialist clinical advice and are passionate about supporting symptom management, improving quality of life, educating and empowering people with MS. But as Kaye discusses, the MS nurses are also often intricately involved in research projects. To find an MS Nurse, please contact your local MS Clinic, nearest MS State Society or MS Nurses Australasia.More resources:MS Nurse Insights (MS Australia)Multiple Sclerosis Specialist Nurses in Australia 2017 - Report (MS Australia)Support & Services (MS Australia)This podcast reflects one individual’s experience with MS and does not take into account the varied nature of MS. The views expressed here do not necessarily reflect those of MS Research Australia or MS Starts Here. It may contain opinions and advice about scientific studies, diagnosis, medications and treatments that are not applicable to your circumstances or your MS and should not take the place of professional advice, diagnosis or treatment. If you are concerned about any of the topics within this podcast please seek advice from your medical team. If you would like further information on any topics of MS research that might be touched on here, visit www.msra.org.au or feel free to contact the MS Research Australia team on 1300 356 467 or enquiries@msra.org.au with your questions.
Jane and Dan caught up with Professor Jason Roberts, NHMRC Practitioner Fellow at The University of Queensland and Consultant Clinical Pharmacist at the Royal Brisbane and Women’s Hospital. Jason is a senior member of the Burns Trauma and Critical Care Research Centre within the University of Queensland Centre for Clinical Research and is Director of the Centre for Translational Anti-infective Pharmacodynamics in School of Pharmacy where he is also Chair of the research Strategies Committee. We could have talked to Jason all day. In part two of our two-part discussion on pharmacokinetic modelling of antimicrobials we talk about: different pharmacodynamic models for antimicrobials: concentration, time and AUC dependant the clinical evidence for using pharmacokinetic and pharmacodynamic modelling future directions for clinical pharmacokinetics
Jane and Dan caught up with Professor Jason Roberts, NHMRC Practitioner Fellow at The University of Queensland and Consultant Clinical Pharmacist at the Royal Brisbane and Women’s Hospital. Jason is a senior member of the Burns Trauma and Critical Care Research Centre within the University of Queensland Centre for Clinical Research and is Director of the Centre for Translational Anti-infective Pharmacodynamics in School of Pharmacy where he is also Chair of the research Strategies Committee. We could have talked to Jason all day. In part one of our two-part discussion on pharmacokinetic modelling of antimicrobials we talk about: Jason's pathway to a research career and the projects that his team are currently working on The patients and pathogens that benefit from individualised dosing of antimicrobials The narrowing therapeutic indices of some antimicrobials Some under-recognised adverse effects of beta-lactam antibiotics how to apply pharmacokinetics and individualised dosing in everyday practice
Cardiac troponin measured with newer generations of analytically highly sensitive assays have been investigated in accelerated discharge protocols on the assumption that they have an improved ability to detect and quantify cardiomyocyte injury more quickly than previous generation’s assays. In the May 2018 issue of Clinical Chemistry, Dr. Jaimi Greenslade from the Royal Brisbane and Women’s Hospital in Herston, Australia, and her colleagues investigated a high sensitivity cardiac troponin I assay to see if a single test threshold can safely rule out acute MI.
In episode 106 of The Physical Performance Show Brad Beer brings you an expert edition and has a conversation with Dr Hal Rice Radiologist (MBBS, FRANZCR) Sports Injuries & Imaging. Dr. Hal Rice obtained his medical degree at University of Queensland in 1992, followed by his residency at the Royal Brisbane and Women's Hospital. Hal then went on to complete specialist training in diagnostic and interventional radiology at the Royal Brisbane and Women's Hospital before undertaking advanced specialist fellowship in diagnostic at interventional Neuro-radiology at the world famous Mt. Sinai Medical Centre in New York. On returning to the Gold Coast, Hal then co-founded QScan radiology clinics, which today has more than 30 locations across Australia, treating more than 430,000 patients annually. Hal also established the interventional Neuro-radiology service at the Gold Coast Hospital and this service is now regarded as one of the premier sites in Australia for the endovascular treatment of life threatening brain aneurisms and acute ischemic stroke. Hal has worked as a diagnostic and interventional neuro-radiologist in the Gold Coast Hospital since 2003. Hal has a major academic interest in obviously diagnostic and interventional neuro-radiology. But also Hal's special interest in sports medicine imaging and musculo skeletal imaging and non-invasive pain management and all fields of advanced magnetic resonance imaging (MRI). QScan is the provider to Swimming Australia, Triathlon Australia and Cricket Australia here in South East Queensland. Hal himself is also a very keen runner and as a Junior, Hal ran in an incredible 2:38 when he fell in love with the Gold Coast Marathon, a race that he won the Junior Category in 3 years in a row, so Hal lives and breathes muscular health and all things medicine. During this episode we discuss the world of diagnostic imaging and interventions for athletes, the importance of getting and establishing an accurate diagnosis of injuries. What that means for the prognosis of the outcome of your injury. We discuss common conditions and common imaging types such as ultrasound, plain film Xrays, magnetic resonance imaging (MRI) and also Hal touches on some of the new muscle fibre typing technologies that brings interest to recreational and elite athletes. Let's hear from Dr. Hal Rice of QScan Technology. Listen in as we delve into the following: How Hal started in Medicine Imaging Technology Hal's change of specialty Running 2:38 in the Gold Coast Marathon QScan business How imaging helps with diagnosis Bone Health Bone Density Tests and Stress Injuries Diagnosing Tendon Injuries Suffering from a tear or injury Working with Back Pain and Neck Pain What is cortisone and when is it appropriate Trends in radiology Bone Muscle Fibre MRI Research on Fast and Slow Twitch fibres Working with professional sporting teams. Physical Challenge If you enjoyed this episode of The Physical Performance Show please hit SUBSCRIBE for to ensure you are one of the first to future episodes. Jump over to POGO Physio - www.pogophysio.com.au for more details Follow @Brad_Beer Instagram, Twitter, and Snapchat Please direct any questions, comments, and feedback to the above social media handles. Powered by POGO Physio, Mermaid Waters
The February 2018 podcast interviews Dr Mark Daglish, Director of Addiction Psychiatry at Royal Brisbane and Women’s Hospital. Dr Daglish has been involved in research into the neurochemistry of craving, the role of craving in relapse, and brief interventions for young people presenting to emergency departments with alcohol related injuries. In the podcast the importance of integrated care of patients presenting with addiction across medical, social, legal, and other services, and the search for maintenance treatments for stimulant users is discussed. Dr Daglish also mentions exploratory efforts to use psychoactive substances such as psilocybin to alter the natural history of addiction, speculating on the possibility of manufacturing the sort of epiphanies that can lead to abstinence.
Episode 10: Musicians' Health features Jo Lagerlow, Jodie O'Brien and Michael Thrum. Health is essential to life, and music has the power to positively or negatively affect one's health. The episode includes various discussions on the role of music in relation to physical and mental health, including musculoskeletal, audiology, music therapy, and music performance anxiety, and how it can affect us as musicians, educators, or contributors to the health of others. The venue featured in this episode is the Royal Brisbane and Women’s Hospital (RBWH). It is Queensland’s largest hospital and provides a wide range of clinical services in the heart of Brisbane. RBWH employs more than 6,000 multidisciplinary staff that together provides life-saving treatment to over half a million people each year. In 2017, RBWH celebrates 150 years of caring for Queensland. The modern-day RBWH supports and produces world-leading research and education, and is a prominent innovator in the pursuit of ever-improving patient outcomes. ‘The Stairwell Project’ curated and directed by Peter Breen, began at RBWH performing live music in various spaces, including the stairwell, foyer, cafeteria, hallways and oncology outpatients area - for more information go to http://www.jugglers.org.au/stairwell-project/. We will be discussing more of this in episode 11, featuring Peter Breen. Hosted by Anna Kho. Recorded and Edited by Daniel Kassulke. Music Credits: Musicians Unmuted Theme by Daniel Kassulke Vermont Counterpoint performed by Jo Lagerlow Brahms 2nd Sonata performed by Michael Thrum Moreton Bay performed by Michael Thrum Searching performed by Jodie O'brien
At the recent 2017 SHPA Residency Symposium, Dan joined Beth Ward, Foundation Program Manager at the Royal Pharmaceutical Society and Ian Coombes, SHPA Vice President and Director of Pharmacy at the Royal Brisbane and Women's Hospital to discuss plans and programs to support and develop our workforce.
In this episode, the host Jan Alford will be discussing the role of metabolic surgery in diabetes with Dr George Hopkins. Dr Hopkins is Visiting Upper Gastrointestinal and weight loss surgeon at the Royal Brisbane & Women’s Hospital and Holy Spirit Northside Private Hospital. He is also an Executive Member of the Obesity Surgery Society of Australia and New Zealand. Most of Dr Hopkins' general surgical practice is now in the field of bariatric and revisional bariatric procedures. He is working in private practice at the Chermside Medical Complex and runs the Surgical Weight Management Clinic at the Royal Brisbane and Women’s Hospital. To download a certificate of completion, please visit https://learning.adea.com.au/lms/course/view.php?id=86 and complete the survey.
Professor Robert Alexander (‘Frank’) Gardiner AM is an academic urologist with the University of Queensland Centre for Clinical Research at Royal Brisbane & Women’s Hospital where he is appointed as Consultant Urologist. Professor Frank Gardiner shares his insights into the trials & tribulations of robotic surgery trials.
Carolyn Lam: Welcome to Circulation on the Run, your weekly podcast summary and backstage pass to the journal and its editors. I'm Dr. Carolyn Lam, associate editor from the National Heart Center and Duke National University of Singapore. I am so excited to be discussing the diabetic HFpEF or heart failure with a preserved ejection fraction phenotype, with world experts and new insights from the I-PRESERVE Trial. That will just be in a moment and here are your summaries first. The first paper in this issue is a systematic review and meta-analysis of risk factors for Co-Arctation of the Aorta on pre-natal ultrasound. In this paper by first author Dr. Familiari and corresponding author Dr. D'Antonio and colleagues from Arctic University of Norway, the authors performed a systematic review of 12 studies on 922 fetuses with echo-cardiography, and found that those with a post-natal diagnosis of co arctation had significant differences in several cardiac morphological parameters compared to cases without co arctation. The presence of a co arctation shelf, or hypoplastic arch, was associated with a significantly increased risk of co arctation. Furthermore, they reported multi-parametric diagnostic models that were associated with an increased detection rate. Thus, this paper tells us that assessment of left inflow and outflow tracts prenatally may help in stratifying the risk of co arctation. The next paper reports pre-clinical data that truly represents a paradigm shift in our understanding of vascular resident endothelial progenitors in tissue regeneration. In this paper by first author Dr. Patel, corresponding author Dr. [Cossroterrani 00:02:00], and authors from Royal Brisbane and Women's Hospital in Australia, the authors studied protein expression levels of common endothelial markers in mice using flow cytometry. They discovered an endovascular progenitor cell in vivo that is present in normal endothelium in the aorta and lungs and activated in vessel walls during various endogenic situations, such as in the placenta, skin wound healing, and tumors. They further define at a molecular level an entirely novel endothelial hierarchy from an endovascular progenitor cell to a mature different-shaded endothelial cell via complete RNA sequencing. They further clarify the linage of endothelial progenitors in their origin by using bone marrow transplantation and vascular-specific, lineage-tracing mouse models, showing that the endovascular progenitor cells were derived neither from bone marrow nor from hematopoietic progenitors. This discovery of an endovascular progenitor cell will have significant implications for the development of endothelial progenitors as a cell therapy. The next paper addresses the chicken or egg question regarding the association between obesity and atrial fibrillation, and this is done using Mendelian randomization to define a causal association between body mass index and atrial fibrillation. In this study by Dr. Chatterjee and colleagues from Massachusetts General Hospital, the authors looked at more than 50,000 European individuals without atrial fibrillation at baseline and showed that genetic variance associated with increasing body mass index were significantly associated with an increased risk of atrial fibrillation. The association between genetically determined obesity and atrial fibrillation persisted even after adjustment for traditional atrial fibrillation risk factors, such as hypertension, diabetes, coronary artery disease, and heart failure. Taken together, these data are consistent with a causal association between increasing body mass index and incident atrial fibrillation. These findings therefore support the primordial prevention of obesity as a significant public health target to combat the expanding global burden of atrial fibrillation. The last paper provides contemporary estimates of the stroke burden in China, a country which bears the biggest stroke burden in the world. In this paper by doctors Wang and Fagen from the Capital Medical University in Beijing, China and Auckland University of Technology in New Zealand, and colleagues, the authors reported results of a nationally represented door-to-door survey conducted in 2013 in 155 urban and rural centers in 31 provinces in China, totaling 480,687 adults. They found that the age standardized prevalence was 1,115 per 100,000 people, incidence rate was 247 per 100,000 person years, and mortality rates were 115 per 100,000 person years. The stroke prevalence estimates in 2013 were greater than those reported in China three decades ago, especially among the rural residents. Finally there was a north to south gradient of stroke in China, with the greatest burden observed in the northern and central regions. Well, that wraps it up for our summaries. Now for our discussion. For our featured discussion today, we are talking about my favorite topic and of course that is HFpEF, or heart failure with preserved ejection fraction, and I am so thrilled to have with us today Dr. John McMurray from University of Glasgow, who's the corresponding author of our featured paper referring to diabetes in patients with HFpEF and really talking about the novel results from the I-PRESERVE Trial. Welcome, John! John McMurray: Thank you Carolyn, it's always a pleasure to speak to you. Carolyn Lam: Oh, I have been waiting for this one, and I'm so excited I don't know where to begin, but how about with this? Diabetes and HFpEF, first of all, haven't we spoken to death about co-morbidities in HFpEF? And secondly, what makes this paper special? Because we've heard about diabetes and HFpEF from CHARM, from DIG, from Relax, so tell us: why the interest in diabetes and HFpEF? John McMurray: Sure, Carolyn. I think you and I have been interested in diabetes and heart failure, that terrible combination, for a long time. But I think there's a lot more interest in it today because, of course, we've had several new clinical trials with interventions to lower blood glucose that have showed both beneficial and potentially harmful effects on the development of heart failure. But really what these trials have highlighted is just how common heart failure is as a complication of diabetes. And we strongly suspect, though we don't know for sure of course, but we strongly suspect that most of that heart failure developing amongst patients with diabetes is probably heart failure with preserved ejection fractions. So, I think the context currently is that what's different about our study compared to the ones that you mentioned is that in I-PRESERVE we measured a number of things that were not available in, particularly, the large clinical trials previously. So, in I-PRESERVE we measured natriuretic peptides, we looked at health-related quality of life, and maybe most importantly of all we had a large echo-cardiographic sub study. So I-PRESERVE is quite different than DIG-Preserved and CHARM-Preserved, and of course a lot larger than the RELAX HFpEF study. Carolyn Lam: I was the associate editor managing your paper and I was so excited about this that I invited an editorial as well by Brian Lindman, and he's got this beautiful table that summarizes what your study really adds to the literature, and I think it's so critical. Could you start by summarizing? What are the main findings? John McMurray: Well, I-PRESERVE, as you know, was a trial of just over 4,000 individuals with HFpEF defined clinically and with an ejection fraction of 45% or above. There was actually a trial comparing the angiotensin receptor-blocker [inaudible 00:09:17] placebo, though in fact there is no difference in morbidity and mortality between those two treatment groups. So we've looked, as you said, at the patients who had diabetes and compared those to the patients who didn't have diabetes. I think there was some very interesting novel information; if you look at the two subsets of patients, they actually don't differ in terms of age and sex and, importantly, in left ventricular ejection fraction. But there are other differences that you would expect; for example, many more of the patients with diabetes were obese. But interestingly, and despite that, the patients with diabetes had higher, significantly higher, NT-proBNP levels. So as you know, obesity tends to be associated with lower rather than higher natriuretic peptide levels, so here we were finding higher natriuretic peptide levels in a subset of patients who were actually, by and large, more obese. And there was no difference in other things that might have accounted for that difference; natriuretic peptides, for example, there was no difference in the proportion of patients who had atrial fibrillation. So that was important, and that's also important when we come to think of outcomes because of course the previous studies reporting worse outcomes in patients with diabetes had not adjusted for natriuretic peptides because they by and large weren't available in the large prior trials. So that, of course, could have accounted for some of the worse outcome. Some of the other things, features, maybe to pick out in terms of baseline characteristics ... one was that these patients had many more features of congestion, so patients with diabetes had more edema, more often had a raised jugular venous pressure and so on, and that's interesting given some of the recent clinical trial data that we might come back to. And even though the [inaudible 00:11:22] class distribution was not different between patients with diabetes and those without, what was very different was health-related quality of life, which was much worse in patients with diabetes than those without. Now you could if you chose to, Carolyn, look at that as saying that physicians weren't assessing worse functional status or symptomatic status in the patients with diabetes, but the patients were certainly self-reporting a much worse health-related quality of life. So those were the, sort of, clinical characteristic differences. We did, as I said, have an echo-cardiographic sub study. There were 745 patients in total in the trial who had a detailed echo study, and there were perhaps more modest differences than I might have expected (and I'd be interested in your opinion about this) in patients with diabetes. So they had a somewhat greater, statistically significantly greater left ventricular mass, they had increased early diastolic mitral inflow velocity through E, they certainly had increased E over E prime increased left atrial areas, so there was some left ventricular remodeling and there was some evidence of increased left ventricular filling pressure, maybe diastolic disfunction. But the differences were not very striking; they were there, and as I said previously, ejection fraction (which most of us regard as perhaps not a very good measure of systolic function) was similar between the two groups. We didn't look at more sophisticated and [inaudible 00:13:09] measures of systolic functions so those could have been different, we just don't know. So that's the baseline clinical features and baseline echo-cardiographic findings. And then, of course, we followed these patients for a median of just over four years and what we found was that the cardiovascular and all cause mortality was about twice as high in patients with diabetes as in those without. And if you adjust for conventional clinical variables, including NT-proBNP, which is individually the most powerful predictor of outcome, you only very slightly attenuate that greater risk associated with diabetes. The risk of heart failure and hospitalization was also about doubled in an unadjusted analysis, but that was more attenuated in the adjusted analysis. But you've also got to remember that, of course, the patients with diabetes were not surviving as long, so the very fact that they had a substantially higher risk of heart failure and hospitalization despite a shortened longevity is important. Then lastly, again I think a fairly unique aspect of this study was that we then added the echo-cardiographic findings into the multi-variable model [inaudible 00:14:33] because it was only a subset of patients in which we had echo-cardiographic measurements. The statistical reliability of this is not as robust as in the main model, but what we saw was that there was more attenuation of the risk associated with diabetes when you added in the remodeling and diastolic dysfunction findings that we saw in the echo-cardiographic sub study. So that's a summary, I think, of the key points. Carolyn Lam: John, I was really impressed and struck by the consistency of the message, which is what I really appreciated. What you added to the field was this consistent message that the diabetic HFpEF just had more signs of fluid overload in general, be it clinical, be it by NT-proBNP, be it by echo. And I thought that was something you said it was a moderate difference by echo; it was enough to be convincing to me, and I really appreciated that. The fact that adding the echo findings attenuated the significance ... you know we went back and forth about that quite a bit together, didn't we? John McMurray: We did. Carolyn Lam: I think at the end it is consistent, it is useful information. It tells me that perhaps some of these outcomes are mediated by this access fluid, to me, at least part of it. And I think that is how we ended up expressing it in the final paper. John McMurray: I think you are absolutely spot on, Carolyn, because I don't think I had anticipated that the features of congestion would be so different. And you are correct in that, of course, correlates very well with natriuretic peptides, with the left atrial enlargement and so on. And then of course (and this is clearly extrapolation) but then of course it makes one wonder about some of the trials with diabetes drugs that we've seen. The TZDs, glycosomes, which calls a little bit of fluid retention, of course precipitating heart failure, and then the opposite recently with the SGLT2 inhibitors which of course are diuretics, and those drugs preventing the development of heart failure. And it does make me wonder if the diabetic phenotype maybe was a little bit of renal dysfunction, some subtle renal dysfunction, is a sodium and water avid phenotype state and that it doesn't take very much to tip those patients into frank heart failure and perhaps we need to think (and I think you might have been alluding to it) think about insuring that we adequately diurese these patients given that in this study where people were supposed to be optimally treated, clearly there was still a lot of evidence of residual fluid overload. Carolyn Lam: I absolutely agree, and yes you read my mind that I was going to allude to the implications for therapies that have a diuretic effect, you know, like the SGLP2 inhibitors and in fact this was discussed in Brian Lindman's editorial, which is a must read. Just another question though. What do you think of peripheral mechanisms contributing to all this? John McMurray: Yeah, obviously there is the kidney aspect that we saw a relatively small difference in estimated GFR. Of course that only tells you one aspect of renal function and the nephron in diabetes may well be sodium avid maybe more likely to retain water. So certainly the kidney as a peripheral mechanism might be very important. And then of course the blood vessels, I mean there's no question that patients with diabetes have more abnormal endothelial function probably have got enhanced vascular stiffness. And of course we know from a long time ago at least in HFrEF (I'm not so sure about HFpEF) but in HFrEF there's evidence that some of the vascular stiffness you see in patients with HFrEF is actually due to sodium in the vessel wall and there's some beautiful old-style clinical physiology experiments showing that if you diurese patients with HFrEF you restore vasodilation you restore basal motor responsiveness. It could also be true in HFpEF though of course patients with HFpEF and many other reasons to have vascular stiffness. So yes, peripheral mechanisms may well be important. Your humoral abnormalities may be more pronounced in patients with HFpEF and diabetes compared to those without diabetes. We don't know because I'm not sure that's been measured very often. Certainly natriuretic peptides are, but what about things like the angiotensin system and arginine/vasopressin and the sympathetic nervous system. You know, there's still so much to study looking at patients with heart failure with and without diabetes because they're really quite distinct. And whatever's going on it makes a big difference the way those patients feel, what they can do, and what happens to them. Carolyn Lam: Yeah, and your study really establishes that. Congratulations once again John, it's just been such a delight chatting with you. John McMurray: Likewise, Carolyn. Carolyn Lam: Listeners, you heard it right here on Circulation on the Run. Don't forget to tell all your friends about this podcast and turn in next week!
Dr Hal Rice obtained his Medical Degree at the University of Queensland in 1992 and then completed his Internship and Residency at the Royal Brisbane and Women's Hospital. Hal undertook specialist training in Diagnostic and Interventional Radiology at the Royal Brisbane and Women's Hospital before doing an Advanced Specialist Fellowship in Diagnostic and Interventional Neuroradiology at the world famous Mt Sinai Medical Center in New York City in 2001 and 2002. Dr Rice talks about the use of state of the art technology to provide minimally invasive endovascular treatment of patients with life threatening brain aneurysms and acute stroke. In the spirit of ideas worth spreading, TEDx is a program of local, self-organized events that bring people together to share a TED-like experience. At a TEDx event, TEDTalks video and live speakers combine to spark deep discussion and connection in a small group. These local, self-organized events are branded TEDx, where x = independently organized TED event. The TED Conference provides general guidance for the TEDx program, but individual TEDx events are self-organized.* (*Subject to certain rules and regulations)
Some kind of hero.