Rick Acland is a rehabilitation specialist based at Burwood Hospital, where he practises in spinal cord medicine and pain management. He is also a consultant at the Christchurch Hospice.
In the past he was an anaesthetist both in Auckland and Christchurch. He has a keen interest in pharmacology and spinal implants.
He is on the Medical Council.
Who needs Pain?
Friday 12 June
Start 09:25am
Duration: 25mins
I have been in Pain for over 25 years!
I am still struggling to understand it.
There are many conflicts: as doctors we are expected to determine cause and provide cure and yet a number of pain syndromes remain a mystery. I would suggest that modern radiological imaging has opened up exciting treatment options but may have also complicated ‘pain management’. Treatment failure brings disappointment.
Pain Management takes time. General Practice is not geared for this.
The bogey of chronic opioid prescription is fraught with fish hooks and yet at times good catches can be made!
Current pain concepts, vogue diagnoses, relevant outcome measures and appropriate primary care pain therapies will be discussed.
A number of medical practitioners love using needles to cure pain!
In this workshop we will discuss various needle options that can be used in general practice. The use of local anaesthetics and other solutions, outcomes and complications will be considered.
GP CME 2009 - Dr Pat Alley
Dr Pat Alley (with Dr
Peter Chapman-Smith)
Pat Alley is Director of Clinical Training
for Waitemata District Health Board and Clinical Associate Professor in
Surgery at the Auckland School of Medicine and Health Sciences. He is a
graduate of Otago Medical School and qualified in surgery in 1973. He has
spent most of his working life in full time academic and hospital
practice. His major research interest is colorectal cancer. He has been a
senior instructor for the Early Management of Severe Trauma programme for
the Royal Australasian College of Surgeons and still teaches this
discipline in overseas countries. For twenty years he has been the
Auckland coordinator of the Doctors Health Advisory Service. He is also
the intern supervisor for the surgical specialties at Waitemata DHB, is on
the panel of performance assessment for the Medical Council of New Zealand
and is frequently consulted on matters concerning the organisation and
function of surgical departments.
Basic Surgical Skills Workshops
Thursday, 11 June 2009
Start 08:30am
Duration: 120mins
Start 011:00am
Duration: 120mins
This will cover aspects of
diagnosis, punch biopsy, anatomy of needles, suture choice, excision
technique and simple suture repair, dog ear repair, principles of wound
healing, and sterile wound care. Instruments provided. Practical incision
and repair with pig skin. (Limited to 24 attendees)
GP CME 2009 - Dr Alex Bartle
Dr Alex Bartle
Alex has been a GP in Christchurch since 1978 and in 2000 began a sleep medicine practice, The Sleep Well Clinic, alongside his General Practice.
In April 2007 Alex left General Practice to concentrate on the Sleep Well Clinics in Christchurch, Auckland and Wellington. He now has additional clinics in Tauranga and Whangarei. The Sleep Well Clinic is designed to offer assessment and treatments for all sleep disorders from Snoring and Sleep Apnoea to Insomnia, from Shift Work to children’s sleep difficulties and the Parasomnias.
Alex is on the Education Sub- Committee of the Australasian Sleep Association, and an inaugural member of the Asia Pacific Paediatric Sleep Association. He was a co-author of the NZ Guidelines for sleep disordered breathing in children. He has just completed his Masters in Sleep Medicine through Sydney University.
Workshop 42 - Sleep Studies, OSA and Insomnia
Saturday, 13 June 2009
Start 4:30pm
Events Centre
Duration: 60mins
There are few essentials to life: nutrition, exercise and sleep. The first two have been studied extensively yet sleep remains largely in the realms of research. Much is now known about the mechanisms and functions of sleep, and it is time to apply much of that research to clinical practice.
The two most common sleep disorders seen in General Practice are snoring / sleep apnoea, and insomnia. They rarely present in such a clear-cut way. The most frequent and important presentation for significant OSA is tiredness.
Insomnia on the other hand, may have many diverse causes with stress being the most common. Strategies need to be implemented to tease out the anxiety, depression and primary insomnias to enable relevant therapy to begin.
In this workshop, the importance of diagnosing and treating snoring and sleep apnoea will be addressed. In addition, strategies useful in General Practice for the correct diagnosis and treatment of those suffering from insomnia will be presented.
The time has come when we should begin to take seriously that third of our lives that should be spent usefully and enjoyably in bed!
Chris has been working with Westpac for the last five years, specialising in leveraged transactions and industry research. He has a comprehensive knowledge of the health sector, having worked with New Zealand listed and corporate healthcare clients, large private medical groups and individual practitioners. Chris has developed Westpac’s healthcare business benchmarking tool, and led a research team to establish health sector specific banking services. Prior to Westpac, Chris spent several years in London working for investment banks in market risk, structured finance, and US equities.
Mr Andrew Grace
Associate - Business Advisory & Corporate Finance
Andrew is a Business Advisory and Corporate Finance Associate based in the Auckland City office. He joined BDO Spicers in early 2006 after returning from two years in the United Kingdom where he held financial analyst roles at Carphone Warehouse, Virgin Mobile and the United Kingdom’s largest car leasing company. Recently, Andrew has been involved in a series of due diligence assignments for a private equity backed roll up of Australian businesses.
Pre-Conference Workshop 3
- Business Management - Amalgamation the Changing Face of Practice Ownership
Thursday, 11 June 2009
Start 8:30am
Duration: 120mins
The general practice business environment has undergone significant change in recent years. The traditional small business practice ownership model is at risk of becoming unsustainable because of the increasing complexity of business management, and there is growing trend away from business ownership.
There is no right answer when it comes to business ownership and a lot depends on the business owner’s personal philosophy and aspirations.
All business models have strengths and weaknesses, however many practice owners are now considering amalgamation because of the potential gains in efficiency, opportunities for professional development and lifestyle benefits.
In this session we will discuss the implications for business owners who are considering amalgamation. We will also overview the key steps in successfully executing an amalgamation strategy, and focus on some key issues such as practice valuation and transfer of assets.
It’s common for a property project to provide a catalyst for amalgamation so we will also look at some of the key success factors and key risks involved in developing a medical centre.
John Campbell is Chair of the Medical Council of New Zealand. He is Professor of Geriatric Medicine at the Dunedin School of Medicine and a consultant physician at Dunedin Hospital. He was previously Dean of the Faculty of Medicine at the University of Otago.
Fit for the new
Professional Environment
Sunday, 14 June 2008
Start 11:00am
Duration: 25mins
The relationship between all professions, the public and the politicians has changed considerably. As recently as 2000 the basis of medical professionalism was seen as " the inaccessible nature of knowledge and the commitment to altruism are the justification for the profession's autonomy to establish and maintain standards of practice and self-regulation to assure quality". (Lancet 2000;356:156-9). There would be many from outside the profession, and some from within, who would maintain that altruism, self-regulation and autonomy are outdated concepts.
There is little doubt that if the profession does not maintain standards, standards set in conjunction with the public for the public good, then those standards will be imposed by other processes. There is enough international precedent to show that when there is evidence of poor practice, and this has not been identified and addressed by colleagues, then public trust is lost. External means of ensuring quality will be developed. Such external quality controls are difficult to impose and often will not identify those aspects of clinical practice which are critical to good patient care.
The Medical Council is required to ensure doctors are fit to practise. We can, under the HPCAA, impose a recertification programme. Alternatively and infinitely preferable, the CPD programmes of the Colleges and other accredited CPD providers can be sufficiently robust to assure the public of competent practice. We suggest that periodic practice assessment by peers should be part of robust continuing professional development.
Dr Stephen Child is a Canadian trained General and Respiratory Physician who immigrated to New Zealand in late 1991. He worked in Dargaville for 2 ˝ years before moving to his current role as the Director of Clinical Training at Auckland District Health Board in 1994. Clinically he has an interest in asthma and general internal medicine with a strong passion for medical education. He is a member of the Medical Training Board and sits on a number of national, regional and local committees with a vision to improve education and training of junior doctors and thereby ensure that New Zealand has a medical workforce that is well staffed and capable to look after the future medical needs of the people of New Zealand.
Medicine Sans Doctors; Workforce Modelling and Future
Friday, 12 June 2009
Start 8:30am
Duration: 30mins
The Health Workforce Advisory Committee suggested that New Zealand needs 3000 new doctors in the next 7 years. Currently we face huge medical shortages throughout the profession, hospitals and community.
Stephen currently sits on the Medical Training Board and the DHBNZ Medical Workforce Group.
During this talk, he will review the current state, drivers of workforce change and likely future changes in New Zealand.
Acute Life-threatening Events – Recognition and Treatment (ALERT) –
Welcome to your waiting room! Meet Dr Worm . . .
Sunday, 14 June 2009
Start 9:20am
Duration: 25mins
The ALERT programme was developed in response to awareness that many cardiac arrests, intensive care admissions and even in-hospital deaths might be preventable with better early care. ALERT teaches how to anticipate, recognise and prevent critical illness at an early stage using a structured and prioritised system of patient assessment and management. First developed in the United Kingdom, this multi-professional programme is internationally recognised. An overview of the programme in an interactive environment will be presented.
Doctor, I'm tired all the
time!
Sunday, 14 June 2009
Start 11:50am
Duration: 25mins
Fatigue is the primary symptom presenting to GPs in up to 8% of consultations. Stephen will present a suggested approach to this symptom with memory verses, aids and possible “pearls”. He will also note the similarities in approach to elevated ESR, night sweats and fever.
Lynne is a general practitioner and sports doctor who has been involved with elite sport for over a decade. Initially with North Harbour Rugby and Netball teams, Lynne is now Medical Director for Basketball NZ, Swimming NZ and the New Zealand Women’s Rugby team (Black Ferns). She also travels as team doctor for the Tall Ferns and the Black Ferns.
Lynne was a doctor in the New Zealand Olympic Health Team in Athens 2004, co-led the Health Team for Melbourne Commonwealth Games in 2006 and led the Health Team at the 2008 Beijing Olympics. She is a supervisory ‘doping’ doctor to FIBA for Oceania events.
Lynne has also been an elected member on the Waitemata District Health Board since 2001.
Pre-Conference Workshops
2 and 11 - Sports Medicine
Thursday, 11 June 2009
Start 8:30am
Duration: 120mins
Thursday, 11 June 2009
Start 2:00pm
Duration: 120mins
I plan to work through four areas of sports medicine highly applicable to general practice and have the attendees work in small groups and report back and discuss their various approaches with the greater group. I feel with nurses and doctors present it is an opportunity to look at how 'practice teams' can work together to manage issues. Some will be injury based and some illness based.
Setting Goals Great and
Small
Friday, 12 June 2009
Start 4:25pm
Duration: 25mins
Targeted at promoting Green prescription with a twist. I plan to challenge my colleagues in how they integrate this programme into their day to day consultations...I will leverage over my work with my general practice patients and my elite athletes...
How I feel we should be approaching assessing the active child...my approach and hopefully some ideas of how to work with children and their families and schools/club/representative sports.
An interactive session working on the preparation required to go away with a team or teams - from before the travel, travel plans and how you work with a team away...
Workshop 48 - Sports
Medicine Case Studies
Sunday, 14 June 2009
Start 9:20am
Duration: 60mins
Several scenarios - real - that I have dealt with both with individual teams and multisport events over the past 2 years.
GP CME 2009 - Assoc Prof Rob Doughty
A/Prof Rob
Doughty (The University of Auckland Dr Mayanna Lund (Cardiologist, Middlemore Hospital) Prof Norman
Sharpe (National Heart Foundation)
Dr Rob Doughty is Associate Professor in Cardiology at the University of Auckland and Green Lane Cardiovascular Service, Auckland City Hospital where he works as Director of Heart Failure Services. He is Director of the Cardiovascular Research Group at The University of Auckland, with a wide range of research in cardiovascular medicine. Subspecialty interests include the management of heart failure and echocardiography. He is currently co-chair of the National Heart Foundation Heart Failure Working Group. He also works in private at The Auckland Heart Group.
Heart Failure
Symposium
Pre-conference
Workshops 4 and 13
Thursday, 11 June 2009
Start 8:30am
Duration: 120mins
Thursday, 11 June 2009
Start 2:00pm
Duration: 120mins
The NZ National Heart Foundation previously released Heart Failure Guidelines in 1997 and 2001. The 2009 revision of the Heart Failure Guidelines has focused on key areas including:
• Diagnosis of the clinical syndrome of heart failure
• Heart failure disease management programmes
• Pharmacotherapy
• Device-based therapies including primary implantable defibrillators and biventricular pacing
• Exercise recommendations and
• Palliative care management of patients with end-stage heart failure.
To support the recommendations, the heart failure patient resources have been completely re-developed with a focus on improving patient self management.
The key recommendations will be discussed in the workshops in a format around case examples. There is opportunity for review and comment on the guidelines at these workshops.
GP CME 2009 - Dr Paul Drury
Dr
Paul Drury
Supported by:
Breakfast Session - Dr Paul Drury
Diabetes in New Zealand 2009 – The Good, the Bad and the Ugly
Graham has worked as a Senior Medical Officer at the Auckland Community Alcohol and Drugs Services (CADS) since 1996. He is a Fellowship of the Australasian Chapter of Addiction Medicine (FAChAM). He has considerable experience with opioid substitution treatment, especially methadone maintenance, and in medical detoxification.
His part time general practice experience dates from 1983. Much of this work involves assessing and managing addictions. He is an FRNZCGP at the Kingsland Family Health Centre.
NZ Family Physician April 2007 has his review paper Drink to your health – is alcohol really cardioprotective? Epidemiological studies have usually shown a J-shaped curve suggesting that moderate drinkers have a lower alcohol-related relative risk of cardiovascular disease than abstainers or heavy drinkers. This paper found that because of confounding and misclassification, such non-randomised uncontrolled studies can never confirm that ‘a few drinks a day are good for the heart’.
(Click for PDF of
this paper)
Addiction
Friday, 12 June 2009
Start 2:25pm
Duration: 25mins
Addictions, like diabetes and asthma etc, tend to be chronic relapsing conditions. They cannot be cured, though many resolve over time. Primary care opens multiple windows of opportunity to support the addicted patient.
A few quick screening questions will rapidly identify most addictions: smoking, drinking, other drugs and even food addictions.
Simple brief interventions can make a difference over time. Harm reduction is often a starting point. Best practice is management in a non-judgmental way.
Workshop 4 and 13 - P or
not to P...Substance Abuse
Saturday, 13 June 2009
Start 11:00am
Energy Events Centre
Duration: 55mins
Saturday, 13 June 2009
Start 12:05pm
Duration: 55mins
Would you like to ‘fly through the night’ with increased alertness, energy and euphoria, lose weight easily, and boost your libido? ‘Speed can be the ultimate party drug.’ Is P the right drug for you? Come to this session and find out!
This presentation discusses the use of amphetamines in NZ. We review their actions and adverse effects.
Finally we look at how to work with amphetamine users: treatments and interventions.
There will be time for discussion – your case histories and questions are welcome.
[Quotes from sorted 3: safer partying drug information guide, CADS, Waitemata DHB, March 2008]
Workshop 45 - How
to...Drug Testing/Occupational Screening
Saturday, 13 June 2009
Start 4:30pm
Millennium
Duration: 60mins
Dr Graham Gulbransen, GP and Addiction Specialist will introduce co-presenter Nick Mcleay, Director of Communications, The New Zealand Drug Detection Agency Limited (NZDDA, www.nzdda.co.nz).
GPs are sometimes approached by concerned parents, teachers or employers requesting drug screening. Child custody cases may involve drug testing.
NZDDA would like to share their expertise on the medico-legal and ethical issues of drug and alcohol monitoring.
The Health & Safety in Employment Act 1992 and its amendments impose legal obligations on all employers to ensure the safety of employees while at work, requiring the identification of hazards and protection from those hazards. Drugs and/or alcohol have been listed as specific hazards in workplaces.
NZDDA statistics for 2008 show that overall 11% of all workers tested returned a positive result for drugs. 70% of those positive results were for cannabis and 21% were for amphetamines.
Almost 1 in 4 workers tested for drugs following workplace accidents returned positive results, up from 1 in 5 in 2007.
A/ Prof Paul Hofman is the Clinical Director of Paediatric Endocrinology, Starship Children’s Hospital and Deputy Director of the Nessie Paykel Clinical Research Centre. He is a principal researcher at the Liggins Institute as well as being involved in both under graduate and post graduate teaching. He holds several positions on national committees including the NZ Growth Hormone Committee and National Newborn Screening Advisory Group. Dr Hofman is also involved in several parent support groups including the CAH and Turner Syndrome society and is the immediate past president of the Prader Willi Syndrome Society.
The Short of
It
Saturday, 13 June 2009
Start 8:55am
Energy Events Centre
Duration: 25mins
Short stature is an under recognized problem in our community. There is ‘heightism’ in our society and growing evidence that short children have reduced self esteem and confidence in adult life. Although short stature usually represents normal variant growth, poor growth is often the earliest sign of underlying disease in children. This presentation will outline a practical approach to the short child particularly focusing on differentiating normal variant growth from pathological causes.
Workshop 2 and 11 - Sex Steroids in Kids – When to get Worried
Saturday, 13 June 2009
Start 11:00am
Energy Events Centre
Duration: 55mins
Saturday, 13 June 2009
Start 12:05pm
Energy Events Centre
Duration: 55mins
Prepubertal childhood is generally believed to be a sex steroid free time. However, this is not always the case, with both premature breast development and pubic hair development occurring in over 10% of children. Although the onset of these signs can indicate underlying serious endocrine problems such as congenital adrenal hyperplasia or precocious puberty, the vast majority of children with these signs are normal. This workshop will focus on the recognition of sex steroid signs in children, differentiating normal variant sex steroid exposure from pathological endocrine problems
Aiden’s journey began with a vision and a mission to develop a national, and international, organisation that realized, equipped, motivated and released tertiary students. This was the proving ground for Aiden’s rising passion in leadership, strategic management and mentoring/coaching skills.
Aiden has developed a passion for strategy and for seeing individuals and groups released into fulfilling their maximum potential. This has led him to help others to move to higher levels of excellence and maximum achievement.
Aiden’s experience to date includes;
• Written and delivered a national qualification (Diploma of strategic leadership) to Boards and Top Management Teams
• Performance Coaching and Strategy Facilitation.
• Aiden regularly consults and facilitates ‘Corporate Strategy’ within a number of organizations.
• Aiden Holliday has spoken nationally and internationally in Denmark, Italy, Hong Kong, Nepal, Cambodia and Australia to audiences in excess of 3000 people.
• Dean of Leadership Vision Leadership College until 2004
• Involvement with Lead-Nepal to train up strategic leaders over the next five years
• Pioneering ‘Cutting Edge’ which in 12 years went from a local to a national to an international organisation.
• Initiated a work in Cambodia, along with the Cambodian Government, to facilitate Conflict Resolution training, and was instrumental in facilitating ongoing work with international experts to continue the work.
• Aiden’s qualifications include MBA (Intl); M. Phil. (Ldrshp), Grad.Dip.Strat.Man, Adv.Cert.Adlt.Teach.
• Aiden is writing a number of books due to be published later this year.
Aiden, his wife Lee and sons Jordan and Jonty live in Hamilton, New Zealand.
Strategic Planning -
Practice Managers Programme
Friday, 12 June 2009
Start 11:00am
Duration: 60mins
Leader, Leaders …. The Vital Link to Success
A good product or service is no longer enough to succeed in the market place. Although important, these things must be accompanied by an excellent strategy that understands the environment as well as highly trained people who can implement this strategy.
With this in mind, a vital link in the success of health initiatives for Primary Health Care is leadership. AH Frontiers acknowledges that we are now in an era where leadership is required and organisational culture and people become the primary assets of any organisation. Today’s health environment requires organisations full of strategic thinkers / leaders with finely tuned skills who can understand the environment, plan and implement strategy. This creates an envisioned, mobile organisation whose success is found in their ability to harness their individual leadership potential and respond to the market demands appropriately.
To date there has been a void of strategic leadership training and education that is applicable for management in general practice, despite the strategic importance of this role and the increasing complexity of the position. This type of training could also be of great benefit to others working in the wider Health Sector.
Over the past 15 years, AH Frontiers has partnered with various organisations to deliver meaningful, life-changing and practical courses and qualification for those in fast paced industries.
GP CME 2009 - Dr Shaun Holt
Dr Shaun Holt
Dr. Shaun Holt is the director and founder of Clinicanz, New Zealand’s only Site Management Organization and The Vitamin Lab, who only supply vitamins and supplements based on good scientific research. Previously, he was the founder of P3 Research, an independent clinical trials unit based in Wellington and Tauranga, and Research Review, a company that produce regular reviews of the medical literature for health professionals. He is Ex-Medical Director of Clinical Trials in the Wellington Asthma Research Group. Shaun holds Pharmacy and Medicine degrees, has been the Principal Investigator in over 50 clinical trials and has over 50 publications in the medical literature. He is Honorary Research Fellow at Medical Research Institute of New Zealand, an Advisor to the Asthma and Respiratory Foundation and a regular contributor on TVone's Breakfast programme and national radio shows.
Workshop 49 - Natural Treatments: What Works?
Sunday, 14 June 2009
Start 9:20am
Duration: 60mins
This workshop will initially cover: what is natural health?; are the sceptics or the believers correct?; links between pharmaceutical and natural products; good research; bad research; natural product research; and the best natural product research from 2007 and 2008.
Then, the session will become interactive and hold debates on: should doctors recommend homeopathy and chiropracty?; can we accept a lesser degree of evidence for natural treatments?; the use of placebos in medical practice; should everyone take a multivitamin and fish oil?
Rod Jackson is Professor of Epidemiology and Head of Epidemiology & Biostatistics at the School of Population Health, University of Auckland, New Zealand. He is medically trained, has a PhD in Epidemiology and is a member of the New Zealand College of Public Health Medicine. He teaches epidemiology and evidence-based health care to undergraduates and postgraduates, both in New Zealand and internationally. His main research interest for over 25 years has been the epidemiology of cardiovascular diseases. He is one of the architects of New Zealand risk-based clinical guidelines for managing CVD risk and is currently leading the PREDICT programme which uses a web-based clinical decision support system to get evidence, about CVD risk and risk management, into and out of primary care practice simultaneously. He has published over 200 peer-reviewed papers.
Workshop 5 and 14 -
Communicating the Real Heart Risks
Saturday, 13 June 2009
Start 11:00am
Duration: 55mins
Saturday, 13 June 2009
Start 12:05pm
Duration: 55mins
This workshop will explore a wide range of tools for communicating CVD risk including a new approach based on heart age. Feedback will be sought for how to improve these tools.
A diagnosis has traditionally involved categorising a patient as either having a disease or not. However most of the current and future burden of disease in middle and high-income countries does not fit this binary paradigm. People with vascular ‘diseases’ such as ‘hypertension’, hyperlipidaemia or diabetes (as well as depression, respiratory diseases and cancers) have a wide range of risk of morbidity and mortality, as do many people yet to be ‘diagnosed’ with one of these ‘diseases.’
For many so-called ‘diseases’ the assessment of diagnosis should be replaced by the explicit assessment of risk. Increasingly electronic risk prediction tools are replacing diagnostic aids in clinical practice. The implications are huge and will be very political as thresholds for intervention will need to be determined by payers rather than practitioners. While this is already happening to some extent, the death of clinical diagnosis and its replacement by risk prediction, will make the political nature of treatment decisions far more explicit. CVD risk prediction is leading this development and the diagnosis of vascular diseases is now of decreasing clinical relevance.
Copies of the CVD Handbook and CDROM will be available at the back
of the room for Prof Rod Jackson's sessions. Further copies
can be ordered from the New Zealand Guidelines Group at www.nzgg.org.nz/cvdhandbook
Maria is currently employed at HealthWEST PHO as a Clinical Nurse Specialist and Project Leader in youth health. In this role she provides support to the practice teams and delivers clinical services in the community through school based clinics and the Waitakere Youth Health Clinic. She has provided education to practice nurses and school nurses across the Auckland region. She is committed to ensure nurses are supported in their practice and led a national team of nurses in developing youth health nursing competencies.
Practice Nurses Programme
- Successful Approaches to Adolescents
Saturday, 13 June 2009
Start 11:30am
Duration: 30mins
How does a practice nurse make the most of a nursing consultation with a young person? We know many young people do go to their general practice for health care but many have identified difficulty in communicating their health needs.
In this session I will address some of the issues young people have identified as barriers to talking to health professionals and how with additional tools the practice nurse can maximise the time spent with an adolescent.
This session will include communication, confidentiality, and how to identify the real issues.
Turn that HPV immunisation into a successful opportunity!
Anita Kharbteng graduated from Lady Hardinge Medical College, Delhi University in India in 1989 with a Bachelor of Medicine and Bachelor of Surgery (MBBS) degree. She is currently employed at Cardinal Health and works in a medical advisory capacity for many Countries, as Cardinal Health works to improve patient care in Asia Pacific. Anita has been an invited speaker at many conferences for her knowledge in Brain Monitoring, Stroke and Vascular Diseases, worldwide. She is a strong advocate for monitoring and caring for the brain and vascular diseases.
Cardinal Health NeuroCare division (formerly VIASYS Healthcare) captures the knowledge and expertise of four companies (Nicolet Vascular, Nicolet Biomedical, Medelec/Teca and Grason-Stadler) representing over five decades of ingenuity and innovation.
The focus is centered around Neurological and Vascular diagnosis; leading to improved patient management and prognosis. Anita has been a key contributor to the advancement of many of these devices; advocating the needs of the Asia Pacific patients and caregivers.
Practice Nurses Programme
- Doppler Screening for Diabetes
Saturday, 13 June 2009
Start 12:00pm
Duration: 30mins
Workshop 38 - Use of a
Vascular Doppler
Saturday, 13 June 2009
Start 4:30pm
Energy Events Centre
Duration: 60mins
The workshop will cover Peripheral Arterial Disease (PAD) in People with Diabetes that can be screened by a simple ABI test using a handheld Doppler and a blood pressure cuff. Participants will be taught the theory and practice of performing the ABI test. This test can be easily performed by nurses or General Practitioners. The ABI has been validated against angiogram and found to be 95% sensitive and almost 100% specific.
PAD is a common cardiovascular complication in patients with diabetes and commonly asymptomatic. Therefore, patients with PAD and diabetes may present later with more severe disease and have a greater risk of amputation. The presence of PAD is a marker of excess cardiovascular risk. It is important to diagnose PAD in patients with diabetes to elicit symptoms, prevent disability and limb loss, and identify a patient at high risk of MI, Stroke, and Death.
The diagnosis is made with a determination of the ABI. It is recommended that patients with diabetes who are >50 years of age have an ABI performed. If normal, the test should be repeated every 5 years. A screening ABI should be considered in diabetic patients <50 years of age who have other PAD risk factors (e.g., smoking, hypertension, hyperlipidemia, or duration of diabetes >10 years).
The American Diabetes Association strongly encourages clinicians to function cooperatively and effectively as teams of specialists in the management of this complex patient population, with the common goal of reducing vascular events - MI, Stroke, and amputation – that too often result in disability, social decline, and death.
Graduated from Calcutta Medical College in India in 1990
Diploma in Psychological Medicine from University of Ranchi, India in 1993
Membership of Royal College of Psychiatrists in
Master of Philosophy from University of London
Diploma on Cognitive Behavioural Therapy from St George’s Hospital and Medical School, London
Fellow of Royal Australian and New Zealand College of Psychiatrists
Completed Psychiatric Training in London from St George’s Rotation and Maudsley Hospital and migrated to New Zealand in 1997. Served as Clinical Director of Mental Health Services in Rotorua till 2006. Additional positions held were Director of Clinical Training, Director of Postgraduate Education in Psychiatry, Intern Supervisor and Director of Area Mental Health Services. Moved to Waikato District Health Board as Forensic Consultant Psychiatrist in 2006. Attached to University of Auckland and Waikato Clinical School as an Honorary Clinical Associate Professor. Have more than 45 publications in peer reviewed journals and have written chapters in text books.
Current area of research is burnout and job satisfaction in New Zealand Psychiatrists.
Practice Managers
Programme
The Science
of Happiness
Friday, 12 June 2009
Start 12:00pm
Duration: 60mins
Happiness is defined as a state of well-being characterized by emotions ranging from contentment to intense joy. It is widely recognised that despite improvement in various aspects of socioeconomic and health indices
sense of happiness has not increased and in fact may have decreased in recent times. Mental health services in most parts of the world have focussed their attention on bringing people with mental disorders and ailments to a neutral emotional state rather than trying to enhance their sense of well being and impart a sense of happiness. The role of Mental resilience, Healthy relationships and Finding meaning in life will be explored in the context of happiness. The construct of happiness will be examined across three dimensions of pleasure, engagement and a sense of meaning. Some additional resources along with work from Auckland University will be presented.
John Mayhew is an experienced Sports Medicine and Occupational Medicine Doctor. He works for Sovereign Insurance as their Clinical Director and also as a Sports Doctor and Occupational Medicine Practitioner on the North Shore of Auckland. He has post-graduate qualifications in Sports Medicine and Occupational Medicine. He is also a Fellow of the Royal College of General Practitioners and has a Diploma in Obstetrics. His current Practice is divided between working as a Clinical Director for Sovereign Insurance looking after the Vodafone Warriors Rugby League side and also has a Private Practice in Sports and Occupational Medicine. He was the Medical Director and All Black Medical Doctor for fifteen years, from 1998-2004. He is currently on the medical advisory Panel for New Zealand Rugby League and is a Director of North Harbour Rugby Union.
Workshop 1 and 10 -
Managing Risk; An Insurers View - Why We Do What We Do
Saturday, 13 June 2009
Start 11:00am
Millennium Hotel
Duration: 55mins
Saturday, 13 June 2009
Start 12:05pm
Millennium Hotel
Duration: 55mins
In this presentation I will explain why and what insurance companies request and why they do what they do. There will be some actuarial data and a description of the various products that are available by insurance companies. These aren’t limited to life or medical insurance products and a description of the underwriting needs for this. Discussion will also be an interaction between the Privacy Commissioner and requesting medical information and why insurance companies require medical information to assess risk. There will be a number of practical examples and a discussion of actuarial principles which will help to explain to Doctors to the difference between what insurance companies need from medical notes and what clinicians require. The main purpose of requesting medical and other information about clients is to assess risk and not provide clinical or financial management.
GP CME 2009 - Prof Rod MacLeod
Prof Rod MacLeod
Is Medical Director of Hibiscus Coast Hospice, Whangaparaoa, Auckland – prior to that he was District Medical Director of Palliative Care (Waitemata DHB).
He is Honorary Clinical Professor in General Practice and Primary Health Care, University of Auckland and Adjunct Professor in the Departments of General Practice and Medical and Surgical Sciences at University of Otago, Dunedin School of Medicine. He was previously the inaugural South Link Health Professor in Palliative Care at the Dunedin School of Medicine, University of Otago (the first Chair in Palliative Care in New Zealand). He has a longstanding interest in education in palliative care completing his PhD work in 2002 with a submission entitled “Changing the way that doctors learn to care for people who are dying”. He has published widely in the area of palliative care in national and international peer reviewed journals.
His book Snapshots on the journey – an anthology of poems through death and remembrance was published by Steele Roberts, Wellington in 2002.
Workshop 24 and 33 -
Complications of Cancer
Saturday, 13 June 2009
Start 2:00pm
Events Centre
Duration: 55mins
Saturday, 13 June 2009
Start 3:05pm
Events Centre
Duration: 55mins
Rod MacLeod
University of Auckland and Hibiscus Coast Hospice, Whangaparaoa
Effective symptom management is one of the cornerstones of high quality palliative care.
This presentation will address some of the more common complications and symptoms that relate to cancer particularly as they present towards the end of life. In particular the recognition of the causes and management of some frequent symptom complexes will be addressed.
The presentation will focus on nausea and vomiting, fatigue and breathlessness; superior vena cava obstruction and malignant spinal cord compression will also be briefly explored. Participants will have the opportunity to discuss their own ‘hot topics’ or ‘problem cases’.
Dr David McNamara is a Paediatric Respiratory and Sleep medicine specialist employed at Starship Children’s Hospital in Auckland. He is a graduate of Auckland Medical School and completed paediatric respiratory training in 2006. He underwent sleep medicine training at Sydney Children’s Hospital. His clinical interests include asthma and obstructive sleep apnoea in children. His research interests include the use of humidification therapy in children with tracheostomies and the assessment of health-related quality of life in technology-dependent children and their families. His wife is a GP. They have 3 active boys who keep them very busy.
Snoring is not cute (Paediatric Sleep
Apnoea)
Friday, 12 June 2009
Start 4:00pm
Duration: 25mins
Obstructive
sleep apnoea (OSA) in children is common, occurring in 1-2% of
children, but is greatly under recognised. OSA in children 2-8 years
of age is usually related to the relative size of the adenoids and
tonsils as compared to the airway. Most children with OSA do not
have obesity. Adenotonsillectomy is the first line treatment for
this condition. In this session I discuss the symptoms and
consequences of OSA in children and when to refer for specialist
assessment or surgery.
The treatment of wheeze in pre-school children is distinct from that of older children and adults. There are distinct phenotypes of wheeze in this age group which may not be responsive to standard asthma treatment. In this session I discuss the difference between “episodic pre-school wheeze” which does not respond to inhaled corticosteroids (ICS) and “multi-trigger” or persistent pre-school wheeze which may respond to ICS. Children in this age group are variably responsive to salbutamol and should only be treated if it appears effective. Prednisolone and long-acting beta agonists should be avoided in pre-school children. I also discus important red flags which might indicate alternate diagnoses and when to refer children with asthma for specialist assessment.
In these sessions I discuss case histories to illustrate features of the diagnosis and treatment of pre-school and school-age wheeze. The emphasis will be on red flags which may indicate diagnoses other than asthma and when to refer these children for specialist assessment. I will also discuss appropriate inhaler device selection for different ages.
Practice Nurses Programme
- Asthma in Kids
Saturday, 13 June 2009
Start 2:30pm
Duration: 30mins
In this case session I will discuss some of the aspects of paediatric asthma management, particularly in those children who are seen frequently. Case histories will be used to illustrate important points.
Zak Moaveni is the Clinical Head of Department of Plastic & Reconstructive Surgery at Waikato Hospital. In addition, as the national Supervisor of Advanced Surgical Training in Plastic Surgery for the Waikato region, he is responsible for the selection and training of future plastic surgeons in New Zealand. His private practice in Hamilton focuses both on aesthetic and reconstructive plastic surgery.
Zak regularly attends national and international meetings both as a participant and lecturer, maintaining close links with colleagues overseas. He is also involved with charitable surgical missions overseas performing repair of cleft lip and palate deformities and other reconstructive procedures.
Pre-conference
Workshops 10 and 14 - Advanced Surgical Skills
Thursday, 11 June 2009
Start 2:00pm
Duration: 120mins
Start 4:30pm
Duration: 120mins
A practical workshop to demonstrate and practice on pig skin some flap repairs suitable for skin cancer work as rotation and advancement flaps. Other flaps as wolfe grafting, split skin grafts, Lazy S and VY repair, and Z plasty will be presented. Discussion on choice of technique, and complications. Instruments will be provided. This workshop is more suitable for GPs with prior surgical experience. (Limited to 24 attendees)
Brendan was appointed as Chief Economist for Westpac in May 2003. Prior to joining Westpac, he spent a couple of years backpacking around the world. He was Chief Economist for the National Bank and has also worked for the NZ Institute of Economic Research. Brendan was educated at Auckland University, and graduated with a Masters, First Class Honours. His work has been published in New Zealand and International journals, he's a regular on the speaker circuit, and provides comment to New Zealand media on key economic issues.
Concurrent Session:
Beyond the Meltdown - Economists View
The Long and the Deep of it
Friday, 12 June 2009
Start 2:00pm
Duration: 90mins
The world economy is going to hell in a handbasket. Brendan will look at past financial crises to find some clues as to how long the current situation might last, and how bad it might get. He'll also look at the impacts on New Zealand, and suggest why the New Zealand and Australian economies may prove winners in the global economic ugly contest.
GP CME 2009 - Dr Alasdair Patrick
Dr Alasdair Patrick
Dr Alasdair Patrick is a kiwi trained Gastroenterologist and General physician employed at Middlemore Hospital in Auckland. He is the director of physician training for Counties Manukau district health board and holds a University of Auckland position. He returned to New Zealand from a consultant post in Singapore two years ago. Prior to this he held a prestigious fellow position in the United Kingdom. His major areas of interest are functional gastrointestinal disease, reflux disease, liver disease and colorectal cancer. He has extensive experience in new technologies that are changing the face of gastroenterology having been formally trained in CT colonography, endoscopic ultrasound, BRAVO pH capsule, pH/ impedance testing, manometry and capsule endoscopy.
Alasdair consults privately at the new comprehensive gastroenterology centre Macmurray Gastroenterology in Remuera, Auckland.
Sigmoidoscopy/Proctoscopy/Inject
Piles
Saturday, 13 June 2009
Start 11:00am
Millennium
Duration: 55mins
Saturday, 13 June 2009
Start 12:05pm
Millennium
Duration: 55mins
The prevalence of haemorrhoids is thought to be 4% of the population. The cardinal features are bleeding, pruritis, prolapse and pain. These may also be the things that you experience when a patient complaining of these perianal symptoms presents to your practice. This session will be an overview of perianal pathology. We will then discuss medical treatments that are available and surgical options. In the absence of volunteers from the audience this session will then be a practical one where you will get the opportunity to perform a sigmoidoscopy on a training dummy.
Diarrhea is a common symptom that creates many diagnostic dilemmas. The differential diagnosis is vast and ranges from benign self limiting causes that require no treatment to sinister pathology. An organized logical approach is essential to minimize unnecessary anxiety and to triage out those who require further investigation and management. This workshop will take the participants on a journey through a decision making pathway that will give them the skills to confidentially approach such patients. We will also touch on appropriate investigations and treatments of various conditions that are encountered.
Shaun joined Medical Assurance Society in 1980. He has held various positions within the organisation to date including Branch Manager, Business Advisor, Regional Manager to his current role of National Manager - Business Advisory Services.
During this time, Shaun has gained extensive knowledge of the private health sector and leads the team that developed HealthyPracticeTM – an online business support service for General Medical, Dental, Veterinary and Specialist practices. Shaun has assisted health sector practices undertake successful practice premises developments, amalgamations, strategic planning processes and many other business undertakings.
Practice Managers
Programme - Governance vs Management
Friday, 12 June 2009
Start 8:35am
Duration: 90mins
In general practice the differences between governance and management can often be blurred. GP’s can be the owner, director, manager and clinician but what hat does he or she wear at what time and what are the responsibilities of each role? Also general practice has complex group practice business models that can sometimes make the lines of responsibility and accountability confusing. This is especially so in a in a cost sharing group practice where individual practice ownership sits outside the group practice.
Capitation based funding, group practice quality standards and increased compliance requires general practice entities to have clear governance and strong management skills to provide quality services, manage risk and be successful. In this session we will explore the different roles and responsibilities of owners, directors and management and discuss some key questions relating to practice governance and management including:
• What are the key roles and responsibilities of owners, directors and managers?
• What is the most suitable group practice business model for today’s general practice environment?
• What is a suitable governance and management structure for a group practice?
Tania Pinfold is an Auckland graduate who has worked in Rotorua for 22 years. She is a GP with a special interest in Youth Health. As Clinical Leader Youth Health in Rotorua, she now works at a community youth health centre known as Rotovegas Youth Health, and in high school wellness centres. She also participates in the Youth Health Advisory Group for the Ministry of Health.
Workshop 26 and 35 -
Towards Healthier Youth
Saturday, 13 June 2009
Start 2:00pm
Millennium Hotel
Duration: 55mins
Saturday, 13 June 2009
Start 3:05pm
Millennium Hotel
Duration: 55mins
We usually assume that adolescence is a time of excellent health. However, comparing all age-groups, improvements in mortality in recent decades are least of all for 15 - 24 year olds.
The health indicators for NZ young people are poor. Statistics for accidents and injuries, mental health, substance use, unintentional pregnancies and STIs suggest that our usual approaches may not be the best.
Most young people do go to GPs. However, we sometimes find it difficult to work out what the important health issues are for an adolescent. And it can be hard to know what to do to make a real difference.
I will teach simple skills that anyone can use to improve communication with adolescents, work out the real issues, and improve compliance. Using these skills, you can maximise the gains and minimise the frustrations of consults with young people!
Michelle is a Registered Nurse currently practicing within the BOPDHB. Originally from the UK, she has been working over the last 11 years within the field of Spirometry providing education to Nurses, GPs and providing peer support sessions for the local Asthma & Respiratory Management Centre.
“Spirometry is invaluable as a screening test of general respiratory health in the same way that blood pressure provides important information about general cardiovascular health”. (GOLD updated summary 2005)
Practice Nurses Programme
- Effective Spirometry in Practice
Saturday, 13 June 2009
Start 3:00pm
Duration: 30mins
During Michelle’s sessions she aims to convey the basic principles outlining the need and practical application of Spirometry in line with Best Practice and GOLD.
Her sessions will include the “Need To Know” about Spirometry, the importance of performing reversibility and taking a detailed medical / symptom history in order to complete the “Respiratory Jigsaw”, of which Spirometry is only one piece.
Michelle offers an easily followed style of learning, taking you on a journey to better understand Spirometry and appreciate what the results actually mean and how these in turn can influence therapy recommendations!
As demands increase within the Public Health Sector it is of paramount importance that the PHO and DHB provide optimum care and screening facilities that are easily accessible to their clients.
Studies performed by Schermer et al 2003 agree that Spirometry testing is justifiable within the community setting provided the staff have received sufficient training and that they perform testing frequently, maintain best practice performing these tests and maintain their spirometers in line with published and respected guidelines.
“Enabling communities to achieve good health and ensure access to high quality services”
(Mission statement BOP DHB)
Spirometry can be performed easily within the community, providing clinicians with objective data that along with a detailed medical history can assist with diagnosis.
Traditionally, Spirometry has been used within the community setting to assess the severity of Obstructive Lung Diseases such as Asthma and COPD. However, centres are now finding Spirometry a valuable addition to their test portfolio. Routine well person checks, occupational health screening, assisting with differential diagnosis of Asthma & COPD and also as an indicator of general respiratory function within the dyspnoeic client population are just an example of the areas benefited.
Workshop 46 - Spirometry
and NO Testing in Asthma
Sunday, 14 June 2009
Start 9:20am
Duration: 60mins
Spirometry is only piece of the jigsaw in assisting with differential diagnosis and measurement of respiratory health . FeNO inflammometry can help take the guess work out of inhaled corticosteroid therapy management as an instant non invasive measure of airway inflammation is obtained, particularly useful when targeting children. FeNO offers assistance with correct diagnosis,insights into steroid effectiveness, steroid does titration that reduces costs and improves patient health outcomes, notification of loss of control & finally identification of poor compliance.
GP CME 2009 - Dr Louise Reiche
Dr Louise Reiche
Dr. Louise Reiche MBChB, FRACP, MD is a specialist physician Dermatologist.
Louise graduated from Otago Medical School in 1985 and completed Dermatology post graduate training (NZ and UK) in 1994. Research work undertaken in England with L’Oreal France, was the basis for her MD, “Self-perceived Sensitive Skin” Otago 2002. Louise works in private practice from Aorangi Hospital in Palmerston North. She runs general dermatology clinics but in addition has special interests in eczema, patch testing, skin cancer surveillance and Vitamin D.
Practice Nurses Programme
- Care of Your Hands
Saturday, 13 June 2009
Start 11:00am
Duration: 30mins
Workshop 25 and 34 -
Looking after your Hands
Saturday, 13 June 2009
Start 2:00pm
Millennium
Duration: 55mins
Saturday, 13 June 2009
Start 3:05pm
Millennium
Duration: 55mins
The skin is an important defence barrier from the outside environment protecting the internal body from fluid loss, invasion by microbes and allergens. Frequent or prolonged exposure to detergents, chemicals, excessive water, humidity extremes, ultraviolet rays and mechanical irritation causes irritant eczema.
We all need to wash our hands frequently to prevent transmission of infections between patients and ourselves. It is important though that the soap is rinsed off well so that there is no residue of soap left on the skin to damage the skin barrier and that the skin is dried thoroughly. Alcohol hand rubs avoid mechanical irritation from paper towels and are less irritating than repetitive soap and water on our hands.
The way we look after our hands at work and at home and with recreational activity impacts on the resilience of our skin barrier.
Gloves may be protective if the fabrics they are made from are suited to the planned activity. Prolonged use of waterproof gloves for more than 20 minutes can cause sweating which is undesirable on the hand skin barrier. This can be ameliorated by use of fine cotton gloves worn inside rubber/waterproof gloves. Tougher cotton gloves are easily washed so are ideal for gardening unless the conditions are wet. Ultraviolet rays from sun exposure when outdoors, working in the garden, mowing lawns, exercising and when driving (UVA passes through window glass) causes cumulative damage to the skin. Densely woven gloves protect against sunlight. Leather may be useful for tougher work such as fencing, DIY building and so on.
When the skin is dry, regular use of a simple moisturiser (perfume free and few preservatives) such as Aqueous cream can help keep the skin flexible. Heavier emollients counter dryness quicker but may not be well tolerated for day time use.
Should you develop hand eczema, treat promptly. Apply clobetasol propionate for a few days to settle the hand eczema and when it is improving change to a moderately potent steroid e.g. Advantan or Elocon ung until the redness and itching has gone. Throughout this time also apply moisturisers every ˝ to one hour to rapidly restore the skin barrier. Your emphasis should be to avoid irritating your hands and maximise recovery by using lots of moisturiser frequently. Use moisturisers for dry skin and apply steroids only for frank eczema.
Skin cancer is the most common cancer in NZ, estimated at 50,000 or more new cases per year and resulting in approximately 260 deaths per year, costing in the order of $33.4 million each year. Exposure to ultraviolet rays (UVR) is the cause of over 90% of all skin cancer cases.
Areas of our bodies that are not covered by clothing may achieve partial sun protection by the use of sunscreen. The standard measurement of sun-protective effect for sunscreens (sun protection factor SPF) measures only UVB protection and is the ratio of the duration of time to produce minimal skin erythema from the sunscreen compared to unprotected skin. Earlier sunscreens may have had inadequate UVA protection, allowing New Zealanders to spend long periods of time in the sun avoiding being sunburnt but being exposed to excessive immune suppressant, ageing and carcinogenic UVA. How to grade UVA protection is yet to be internationally agreed upon. It is recommended that broad spectrum (reducing UVA and UVB transmission) sunscreens be used. Daily use of broad-spectrum photoprotection sunscreen can significantly reduce UV-induced skin damage, BCC and SCC skin cancers and if used regularly in early life, can reduce lifetime skin cancers by 80% and might reduce naevus counts and subsequent melanoma risk.
Sunscreen components are grouped into inorganic (physical /non-chemical) and organic (‘chemical”) filters. Titanium dioxide and zinc oxide are inorganic, photostable, not absorbed systemically, and have not been reported to sensitise (cause allergic skin reactions). They work by reflecting and diffusing UVR. Decreasing particle size to microionised form (10-50nm) compared to 200-500nm of non-micronised form, improves cosmetic acceptability of these agents (which otherwise leave a cosmetically unacceptable white colour). Organic filters absorb UVR energy to a various extent within a specific range of wavelength and the absorbed energy is converted to unnoticeable infrared (heat). Broad-spectrum filters have a high level of absorption in both the UVB and UVA ranges.
Adequate vitamin D status is essential for good health. It helps bone, joint, muscle and neurological function, calcium regulation, hair growth and development and may help prevent or improve the outcome of some cancers and autoimmune diseases.
We can obtain vitamin D from oily fish, eggs, milk, liver, lamb and fortified foods but we generate most from our skin. Vitamin D production is maximal at suberythemal doses of UVB. Further UV exposure degrades cutaneous vitamin D. People who are elderly, indoor or fully clothing-bound, darkly pigmented, obese, babies of vitamin D deficient mothers are at greatest risk of Vitamin D deficiency and may require oral Vitamin D supplementation. Those who are exercise outdoors have highest levels of Vitamin D.
Most New Zealanders therefore, who choose to eat a healthy diet, take outdoor exercise most days, will get adequate vitamin D and maintain general body health. Advise to cover up, wear a hat and apply sunscreen to areas not covered by clothing whenever the UVI is greater than three, but always all year round to those who have had skin cancers or are immunosuppressed.
Dr. Louise Reiche
Dermatologist, Aorangi Consulting Rooms, Palmerston North
Non-melanoma skin cancer refers to the commonest skin cancers, basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). They are the commonest human tumour. There are about 50,000 new cases, in NZ, causing several hundred deaths and costing over $30 million per year. The majority are caused by cumulative ultraviolet radiation, the number of SCCs rising in proportion to sun exposure and on direct sun exposed sites e.g. hands, forearms, upper face and lips. BCCs are more frequent, related more to intermittent recreational sun exposure and arise in less direct sun-exposed sites e.g. inner canthi, retroauricular areas on head and neck. They grow and metastasise slower than SCCs. Larger and higher risk location and histological subtypes of skin cancers are best surgically excised with wide margins. Small and precursor lesions such as actinic keratoses and Bowen’s disease may be treated with a range of modalities including topical agents e.g. imiquimod and 5-fluorouracil, or cryotherapy, photodynamic therapy and radiotherapy.
Sun protection and regular sunscreen reduces the rate of development of new lesions so practical advice on holistic sun protection strategies is very important in secondary prevention.
Mrs. Belinda Scott is currently working as a Breast and General Surgeon at Breast Associates in Auckland and is the Managing Director.
She is a graduate of Otago Medical School and qualified in 1981.
Belinda has been Chair of the Medical Committee of the New Zealand Breast Cancer Foundation for the last 10 yrs. This is a Charitable Trust which is involved in education, research, grants and helping women with treatment and care for early and metastatic breast cancer.
Belinda is the Patron of Pink Pilates. This is a programme designed to improve movement and strength after breast cancer surgery by using physiotherapy principles and emotional support.
Belinda is a member of the Auckland Breast Cancer Study Group.
Breast Associates is a Multidisciplinary Clinic with 3 breast physicians and 3 surgeons. There is dedicated Radiology on site with state of the art MRI, Digital Mammography and a team of Radiologists.
Belinda is interested in women’s health and undertakes all aspects of breast surgery including breast cancer, reconstruction, augmentation and reduction surgery.
Workshop 40 and 47 -
Breast Cancer Screening and Treatment
Saturday, 13 June 2009
Start 4:30pm
Energy Events Centre
Duration: 60mins
Sunday, 14 June 2009
Start 9:20am
Energy Events Centre
Duration: 60mins
Breast Cancer remains the leading cause of cancer-related deaths in females in NZ.
Over 2500 new cases are expected this year and over 600 women will die.
The number of Maori women diagnosed with breast cancer is similar to other NZ women.
However, Maori women are 40% more likely to die from breast cancer.
Is this because they present late or do they have more aggressive disease?
What can we do to try and encourage more Maori and Pacific island women to attend screening programmes?
The first 20 minutes I will spend on what is Screening, Who to screen and When.
I will discuss Population advice versus the Personal advice to give to patients.
A brief outline of all imaging tools will also be discussed as will the benefit of adding in clinical examination to screening.
The next 20 minutes will be on Breast Cancer Management. What is best and current practice?
A brief outline of management of a breast lump or thickening will also be given with an algorithm for this.
The last 20 minutes will be for questions and allow time if needed on Breast Cancer Trials , Auckland Breast Cancer Register and other resources that are available for GPs to use .
Professor H. Peter Soyer, MD, FACD,
has been recently appointed by the University of Queensland to chair
the newly founded Dermatology Group on July 1, 2007. He is located
at the Princess Alexandra Hospital (PAH).
He has published many articles in high-ranking journals in the
fields of dermatology, dermatopathology & pathology and also in
oncology. The content of his scientific oeuvre represents research
in clinical dermatology and dermatopathology with special emphasis
on clinico-pathologic correlation. He has particularly published
numerous articles in dermoscopy of pigmented skin lesions and he can
be regarded as one of the pioneers of this non-invasive diagnostic
method in Europe and possibly worldwide. In the last years he
focused his scientific activities on teledermatology,
teledermatopathology and teledermoscopy and established recently a
Research Unit of Teledermatology within the Department of
Dermatology at the Medical University of Graz. In 2002, Professor
Soyer founded the telederm.org project, an Internet platform for
freely available teleconsultations in dermatology.
Professor Soyer is co-founder and currently president of the
International Dermoscopy Society and was congress president of the
First Congress of the International Dermoscopy Society held this
April in Naples. He is also co-founder and president on the
International Society of Teledermatology and organized the First
World Congress of Teledermatology in Graz in November 2006. On the
national level in Austria he is auditor of the secretary-treasurer
of the Austrian Society of Dermatology and member of the National
Telemedicine Taskforce.
He is on the editorial board of Dermatology of several high-ranking
dermatological journals and has initiated several high profile
postgraduate educational activities on dermoscopy including an
annual “International Short Course on Dermoscopy” held annually
in July in Graz and a purely e-learning “International Dermoscopy
Diploma”, which started in October 2006 on the Virtual Medical
Campus of the Medical University of Graz.
Pre-Conference Workshop 7
and 15 - Dermoscopy
Thursday, 11 June 2009
Start 11:00am
Duration: 120mins
Thursday, 11 June 2009
Start 4:30pm
Duration: 120mins
Introduction
Dermoscopy is an optical, in-vivo technique that has gained recently popularity as an aid to the clinical diagnosis of pigmented, benign and malignant, melanocytic and non-melanocytic skin lesions. The improvement in diagnostic accuracy of pigmented skin lesions compared to the clinical examination is based on the uncovering of specific, submacroscopic, morphologic key structures located in the epidermis down to the upper dermis that are usually not visible to the naked eye. Most of the established dermoscopic criteria correspond to specific, underlying histopathologic structures and vice versa, and as a result, dermoscopy can be seen as a link between the clinical (macroscopic) and histopathologic (microscopic) examination with histopathology regarded traditionally the “golden standard” in the diagnosis of PSL.
Aim
The learning objective is to provide the participants with a simple and systematic procedure for improving diagnostic performance and clinical management of pigmented skin lesions by using dermoscopy.
Content
From a practical point of view, dermoscopy has to be considered a two-step diagnostic procedure. In the first step an algorithm of dermoscopic criteria is applied for differentiating melanocytic from non-melanocytic pigmented skin lesions. When a given lesion is judged to be melanocytic then various diagnostic approaches can be applied in the second step for differentiating benign melanocytic lesions from melanoma. In this teaching module the participants will be provided with many examples of melanocytic and non-melanocytic pigmented skin lesions and all diagnostic criteria will be reviewed in the context of the current practice of dermoscopy. Special emphasis will laid on the impact of dermoscopy on the clinical management of pigmented skin lesions, in other words if a given lesion should be removed or followed-up.
First Step for differentiating melanocytic from non-melanocytic lesions
• Criteria for diagnosing melanocytic lesions
• Criteria for diagnosing basal cell carcinomas
• Criteria for diagnosing seborrheic keratoses
• Criteria for diagnosing vascular lesions
• Criteria for diagnosing dermatofibromas
Second Step for differentiating benign melanocytic lesions from melanoma
• Criteria for diagnosing melanoma using melanoma-specific criteria
H. Peter Soyer, MD, FACD
Dermatology Research Centre
The University of Queensland
School of Medicine
Princess Alexandra Hospital
Brisbane, QLD 4102
Australia
Email: p.soyer@uq.edu.au
NZ and Oz are both thought to be the World Capitals of Melanoma and there is sufficient epidemiologic data out there to support this notion.
This presentation will focus on recent aspects of the morphologic diagnosis of melanoma ranging from dermoscopy and reflectance confocal microscopy to histopathology and molecular biology of melanoma. Refined morphological classification of primary melanomas can improve existing melanoma classifications by allocating subgroups that are genetically more homogeneous and likely to differ in important clinical variables such as outcome and pattern of metastasis. Another exciting finding is the distribution and significance of occult intraepidermal tumor cells surrounding primary melanoma which seems to explain the well known conundrum of melanoma recurrence despite wide excision.
Today we are at the thresholdof a new biology in histopathology, and one can predict that our beloved classic morphology will soon be replaced by new technologies. In the meantime, a combined morphologic approach linking dermoscopy and histopathology might be helpful for pathologists to come to more reliable diagnostic conclusions for patients and their physicians.
Fiona Stewart trained in cardiology at Green Lane Hospital and in Obstetric Medicine at National Women's Hospital. Fiona is a general cardiologist with particular interests in maternal heart disease in pregnancy, heart disease in women, preoperative risk assessment for non-cardiac surgery, atrial fibrillation, heart failure and hypertension. She is a co-author of the NZ Guideline on The Appropriate Prescribing of Hormone Replacement Therapy.
Supported by:
Heart
Failure; Can I Improve Life for my Patient
Friday, 12 June 2009
Start 9:50am
Duration: 25mins
Heart failure is the leading cause of hospital admission in the over 65 age group in New Zealand and a major cause of morbidity and mortality. Optimal medical therapy and lifestyle interventions have been shown to improve the quality of life for patients with heart failure and to reduce mortality and the need for hospital admissions. Ongoing community management of patients with heart failure will be discussed with particular reference to the new NZ Heart Failure Guidelines
Practice Nurses Programme
- Cholesterol Strategies
Saturday, 13 June 2009
Start 12:30pm
Duration: 30mins
Understanding
cholesterol abnormalities, their role in cardiovascular diseases and
management of abnormal lipid levels will be discussed. The
importance of lifestyle interventions and lipid lowering medications
including improving adherence to treatment and management of side
effects will be discussed.
The session aims to provide a framework with which to approach an ECG including the normal ECG, arrhythmias and ischaemic changes. It will be interactive with clinical illustrations and management discussions to accompany the ECG abnormalities.
Currently a physician in private practice in Auckland, undertaking 60% sleep work, 40% respiratory work and specialist diving related consultations. Clinical Director of Auckland Physiology (Private Lung Function Laboratory and Sleep Laboratory).
Part-time clinical member of the Division of Medicine at Middlemore Hospital and clinical teacher for the Auckland University Medical School. Consultant to the RNZN in Diving and Hyperbaric Medicine.
Special interests include diagnosis and management of obstructive sleep apnoea and snoring. The acute application of non-invasive ventilation within acute medical services. Interventional bronchoscopic techniques in the diagnosis and management of lung diseases.
Dr Gerard Walker worked for four years as a Christchurch GP, and then chose to specialise in occupational medicine. Gerard has worked as an occupational physician for a variety of Christchurch employers and has also worked for ACC for seven years. His current role for ACC is that of Director of Workwise Christchurch. In that role Gerard does medicolegal work, trains and supports staff, and has a particular focus on work-related injuries and disease, as well as rehabilitation improvement.
Dr Mike Causer
Dr Mike Causer is a General Practice Fellow who worked in primary care with an interest in sports medicine before going on to specialise in occupational medicine. He is currently the occupational physician for the Canterbury District Health Board, provides independent consulting services to industry and assists with education and training projects at ACC Workwise.
Workshop 50 -
Forearm Pain Guidelines - Go on, twist my rubber arm
Sunday, 14 June 2009
Start 9:20am
Duration: 60mins
Diagnosing and managing work-related distal upper limb pain often proves challenging. The workshop titled “Go on, twist my rubber arm” will be an interactive and multimedia session that will provide practical tips and highlight relevant evidence that can be used to make work-related distal upper limb pain a more manageable problem for both you and your patients.
Louise Webster has trained as both a Child and Adolescent Psychiatrist and a Paediatrician. She is the Clinical Director of the Starship Paediatric Consultation Liaison Team, a child mental health team that works with children and adolescents who have significant medical and surgical conditions. Louise is also a Senior Lecturer in the Dept. of Psychological Medicine at the University of Auckland and teaches on a number of undergraduate and postgraduate courses.
Sad and bad – picking up significant child and adolescent emotional and behavioural problems in a general practice setting
Friday, 12 June 2009
Start 2:00pm
Duration: 25mins
Emotional and behavioural disorders are common in children and adolescents and lead to significant morbidity. The majority of such young people do not present in a primary care setting with psychological symptoms as their presenting problem, and most are not be seen by mental health services. This presentation covers quick routine screening and brief assessment for common disorders, together with first-line management strategies.
I’m fat – assessment and management of the young person with an eating disorder in a general practice setting
Saturday, 13 June 2009
Start 9:20am
Duration: 25mins
Eating disorders are increasing in prevalence in children and adolescents, with more presentations in the younger children. Younger people decompensate metabolically and physiologically more abruptly and rapidly than older people when their weight drops, and they are at greater risk of irreversible emotional and physical impacts.
This presentation focuses on the early recognition and management of children and adolescents with anorexia nervosa, at risk eating patterns and bulimia, who are being seen in a primary care setting.
Workshop 19 and 28 - Aches and
Pains – managing the child who presents frequently with somatic symptoms
Saturday, 13 June 2009
Start 2:00pm
Energy Events Centre
Duration: 55mins
Saturday, 13 June 2009
Start 3:05pm
Energy Events Centre
Duration: 55mins
‘Aches and pains – managing the child who presents frequently with somatic symptoms’
Children who present frequently with medically unexplained symptoms have higher levels of anxiety and depression and function less well at school and socially. In this workshop we will look at assessment and management strategies for such children and their families.
Jenny Westgate works at North Shore Hospital and practises both obstetrics and gynaecology. She is also the Clinical Director for Gynaecology at Waitemata DHB. She is involved in undergraduate and postgraduate education through her role with the university and as a member of the New Zealand Training and Accreditation Committee for RANZCOG. She is a reviewer for the HDC, ACC and the Medical Council.
Workshop 7 and 16 -
Mirena IUD/Pipelle Sampling
Saturday, 13 June 2009
Start 11:00am
Energy Events Centre
Duration: 55mins
Saturday, 13 June 2009
Start 12:05pm
Energy Events Centre
Duration: 55mins
This workshop will briefly review indications for Mirena insertion and Pipelle sampling followed by a demonstration of the techniques and lots of opportunities for participants to practice using pelvic models and to discuss clinical problems.
We are actively canvassing workshop participants to see what topics YOU want covered in this session. Management of abnormal menstrual bleeding and period pain are likely topics to get us going but the remaining content will be determined by participants.
John Anthony Williams is currently a director of Healthpoint limited. Healthpoint was started 5 years ago and has been successful in managing and supporting medical services in the provision of information for both consumers and referring medical professionals.
John has had an extensive background in the private healthcare sector working for large multinationals both overseas and in New Zealand over a period of 20 years. John has also provided consultancy services to corporations throughout the Asia/Pacific region.
Workshop 27 and 36 - GP
Profiling and Improved Referral
Saturday, 13 June 2009
Start 2:00pm
Millennium
Duration: 55mins
Saturday, 13 June 2009
Start 3:05pm
Millennium
Duration: 55mins
1) Improved Referral Information for patients and doctors referring into a DHB/Private provider.
www.healthpoint.co.nz helps people better understand and use New Zealand health services. The Healthpoint website is an award winning portal that publishes information about hospital, medical specialist, general practice and maternity services.
Prior to the inception of www.healthpoint.co.nz
there was no single access point where the general public and referring doctors could go to get information on specialists or a hospital department or service . Healthpoint’s aim is to provide that single access point for doctors, patients and caregivers to source up-to-date, relevant information about New Zealand primary, secondary and tertiary medical healthcare services.
The site provides patients with information about what to expect prior to, during and following referral. It also provides GPs with access to appropriate referral information into DHB services via a secure environment. The DHB/private specialist services input the information directly and Healthpoint supports and manages this information with strict quality and process controls. Healthpoint is also involved in e-referral projects nationally.
2) General Practice Profiling
Following implementation of the GP model in the ADHB region in July 2008 there are 100 general practices profiled on Healthpoint. The objectives for profiling GP practice information include:
• To help the public find information, which will lead to better decisions about what step next to take.
• To help them understand what providers are available and what services are offered.
• To help people with high needs find the appropriate provider.
This information is accessible free of charge via the internet and kiosk technology in the community. This GP model can be provided to other DHBs or PHOs.
Dr Young is a medical graduate of the University of Otago and was awarded a Commonwealth Scholarship which enabled him to graduate from the University of Oxford with a PhD in Molecular Genetics. He has been a consultant Physician in the Department of Medicine, Auckland City Hospital for the last 10 years and recently promoted to Associate Professor jointly appointed in the Faculties of Health and Medical Sciences and the School of Biological Sciences at the University of Auckland. Currently he lectures to medical students and post-graduate science students. His research and clinical interests focus on the early diagnosis and primary prevention of smoking related respiratory disease.
Genetic Testing in
Primary Care
Friday, 12 June 2009
Start 9:00am
Duration: 25mins
With completion of the Human Genome Project considerable advances have been made in the identification of genetic variants (polymorphisms or SNPs) and disease susceptibility. This presentation will review the role of genetic testing in primary care to aid in the prevention and/or early detection of common medical diseases. It will focus on Dr Young’s research interest of susceptibility to lung cancer and chronic obstructive pulmonary disease.
Several cases will be presented in an interactive fashion that will highlight the clinical relevance of spirometry, some pitfalls in the measuring process and utility in improving outcomes for patients.
Over the last 5 years there have been a number of studies examining the diverse actions of statins in lung disease primarily chronic obstructive pulmonary disease and lung cancer. This presentation will review the epidemiological, animal and pharmacological studies that suggest statins may, through immune modulating action, be as effective in preventing respiratory disease as they are in reducing cardiovascular disease.
COPD is a disease of insidious onset that remains grossly under-diagnosed. It is characterised by airflow limitation detected non-invasively through spirometry and associated with poor outcome in people regardless of their smoking exposure. Airflow limitation is a sign of end-organ damage and a general susceptibility to systemic inflammation underlying cardiovascular disease and the airway inflammatory diseases of COPD and lung cancer. Spirometry is not just a test of lung function but a biomarker of premature death from cardio-respiratory disease.
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