General practitioners residing on the North Coast are invited to attend the Northern Rivers General Practice Network (NRGPN) Annual General Meeting on Thursday, 14 December 2017 at 6.30 p.m. The meeting will be held at the St Vincent's Education Centre, Dalley Street, Lismore. Those unable to attend may vote by completing the Proxy Form and returning it to the NRGPN prior to 8 December.

There are three Director positions to be filled on the Board for the 2018-2019 period and members are invited to nominate for these positions. The Nomination Form should reach the NRGPN via email or fax before close of business on 7 December 2017. A NRGPN Board position currently carries a stipend set at $2,000. 

The AGM Agenda includes acceptance of the Minutes of the 2016 AGM and Financial Statements and presentation of the Chairman's Report.

The meeting will conclude at 7.00 p.m. and be followed by a one hour discussion on the future direction for the NRGPN.

Speakers John Langill of North Coast General Practice Training, Dr Louise Imlay-Gillespie, haematologist Northern NSW Local Health District, and local GP, Dr Arthur Proudfoot, will present their ideas for improving medical communication and education on the North Coast.

The Future Directions discussion is open to both members and non-members.

Dr David Guest 

 

Do not go gentle into that good night,
Old age should burn and rave at close of day;
Rage, rage against the dying of the light.

...

Do not go gentle into that good night
Dylan Thomas, 1914 - 1953

The Pap smear is gone. Welcome the CST (Cervical Screening Test). December 1 marks the change over to the new system. General practitioners have been inundated with information about the new test but on page 23 Dr Ruth Tinker gives the one page guide for the busy GP.

Change in medical practice happens slowly but the understanding of the biology of human papilloma virus and the advent of early virus detection together with a nationwide vaccination program will further reduce the mortality from this deadly disease. The management of positive results will be addressed in a subsequent article.

female icons

A new cervical screening began nationally on 1 December 2017.  It will use an HPV DNA test rather than examining cervical cells on a microscope slide (Papanicolaou test). The sample is still collected from the cervix using a vaginal speculum to ensure accurate collection.

So from the point of view of the woman being screened, the process is the same. However because of greater accuracy, if negative, the screening interval will extend to five years. Practices will need to review their recall protocols to conform to the new program.

The program is based on an understanding that more than 99 per cent of cervical cancer is caused by HPV. This includes squamous cell and adenocarcinoma. A third type of cervical cancer, neuroendocrine or small cell cervical cancer, is often more aggressive, but accounts for less than 1 per cent of cervical cancers. Neither the Pap test nor the new Cervical Screening Test effectively detects neuroendocrine cancers.

All women who have symptoms still need investigation, regardless of when they were screened last.

Your brain knows more than you think

 

Your Brain Knows More Than You Think   - the new frontiers of neuroplasticity
Niels Birbaumer (Scribe 262 pp)

Lamenting how society ascribes ‘immutability’ to our brains, psychologist and neurobiologist Niels Birbaumer sets out to explain how the latest brain-machine interface (BMI) technology can help address a range of severe conditions, and in so doing mounts a strong case against euthanasia.
While he may be just the latest author to explore neuroplasticity, “the virtually limitless capacity of the brain to remould itself,” he takes a different, i.e. more technological, tack to the likes of the great Norman Doige (The Brain that Changes Itself, and The Brain’s Way of Healing).
The main difference is the use of BMI, which in various forms creates a ‘neurofeedback’ loop in a series of steps, from the brain to MRI signal reception, thence brain-image transfer and signal analysis by computer program, transfer of processed brain activity to the BMI software and finally, feedback of blood flow in the brain.

Ruth and her cousin at Neko Harbour with flag showing the continent of Antarctica.

Antarctica has been on my bucket list for many years. Earlier this year I ticked that box.

After meeting the group in Buenos Aires we flew to Ushuaia, the main departure point for the Antarctic Peninsula. Our ship Ocean Endeavour took 199 passengers but was dwarfed by the Princess cruise liner moored across the dock, and another expedition ship still bigger than our own.

We set sail through the Beagle Passage, and rumours soon circulated that we had “Shackletons aboard”.  Indeed, we did have some distant cousins of the famed Sir Ernest Shackleton, who were soon sharing stories of the great man’s exploits. The journey became infused with the Shackleton influence with several of our landings linked to the story of the miraculous rescue of his crew from the Endurance. 

One of our landing groups was named ‘Shackleton’, the others ‘Crean’, ‘Worsley’ and ‘Wild’ in recognition of some of his team.