Dr David Glendinning

David Glendinning is an advanced trainee studying for his fellowship in general practice. When he is not studying he suffers déjà vu with his friends and family.

“Hi mate, haven’t seen you for a while,” says David’s mate.

“Yeah, sorry mate, I’ve been studying.”

“Studying? What I thought you were all done?”

“Not quite. I’ve been studying for my Fellowship.”

Jenny Dowell (right, as Clairee) and Elyse Knowles (left, as Annelle) in Steel Magnolias

These days nearly all of us are lucky enough to retire in reasonable health. After a lifetime of making critical decisions day in and day out, with others supposedly following our every instruction, the shift to retirement can be a shock. Some come to suffer what former Labor politician Gareth Evans called “relevance deprivation syndrome”. 

Keeping active in mind and body is the key to warding off the vicissitudes of old age or at least delaying them. 

Some research in this area is being undertaken by the Maintain Your Brain study, funded by the Australian National Health and Medical Research Council. The study is a randomised controlled trial of multiple online interventions designed to target modifiable risk factors for Alzheimer's disease and dementia. Risk factors to be addressed are physical inactivity, cognitive inactivity, depression/anxiety, overweight and obesity, and poor dietary habits. 

Our cover this month is the painting “Love 2019” by local artist Katka Adams. Katka has explored the refugee experience in her recent exhibition “Coming Home”. She describes her inspiration and motivations below and on Page 15 editor, Robin Osborne details her journey of  escaping the Soviet crushing of the Prague Spring in 1968 and the start of a new life in Australia as “that Czech girl”.

Dislocation from one’s cultural roots is a common experience for many Australians from European, African and even Aboriginal backgrounds. For some art gives voice to their experience, for others it is the written word.

I believe - That the Lord God created the universe
I believe - That he sent his only son to die for my sins
And I believe - That ancient Jews built boats and sailed to America
I am a Mormon! And a Mormon just believes
I Believe, from The Book of Mormon, by Trey Parker, Matt Stone and Robert Lopez

The Book of Mormon, the No. 1 hit musical in Australia, follows the journey of two devout young men as they set off on their mandatory two years of missionary work far from their home in Salt Lake City, Utah where the church is headquartered..

The Book of Mormon is the work of South Park creators, Matt Stone and Trey Parker, which as be expected given this pedigree is irreverent, scatalogical and confronting. In short, not the normal fare of religion, making its success with mainstream audiences seem highly improbable, even though its central theme touches a cord for the religious and irreligious alike.

An iceberg analogy of the interactions between lifestyle/environmental determinants

In clinical practice it is very easy when looking at the causes of chronic disease to focus on risk factors and markers by performing measurements and blood tests on a patient. It is well known that abnormalities in these indices can lead to low grade chronic and systemic inflammation called meta-flammation, which in turn leads to chronic disease.

In this process it is easy to blame the patient for ‘letting themselves go’ with unhealthy lifestyles such as poor nutritional choices, inactivity, smoking and alcohol dependence etc. However behind these lifestyle behaviours there are more subtle causes of chronic disease that should not be ignored. These are often referred to as the social determinants of health.