Dr Nathan Kesteven

The Northern Rivers General Practice Network has continued to support and advocate on behalf of general practitioners over the last 12 months. It has represented general practice through its membership of the North Coast Primary Health Network and from members’ participation in the Northern Clinical Council of the NCPHN.

Areas of particular focus for the NRGPN in the Council have been information and communication technology, Aboriginal health, improved care of refugees and arguing for better integration of health care between the NSW State run local prison system and the better funded and organised Medicare system. 

Master cabinet maker Geoff Hannah with former student Colin Fardon and the latter’s creation, Three Little Birds, sold for $68,000.

Robin Osborne meets local cabinet maker Colin Fardon, a master craftsman in the making.

A chance meeting at a party in Brisbane has resulted in Casino-born woodworker Colin Fardon selling his milestone creation for the astounding sum of $68,000 and in the process deciding to become a cabinet maker full-time.

“Now I can give up the day job and follow the dream,” Colin joked as he carefully handled one of the beautifully crafted drawers from his inlayed collector’s cabinet titled “Three Little Birds”.

The work is part of the exhibition Chesta Drawz and the LowBoys that ran recently at Lismore Regional Gallery. The other works, less ambitious in scale but also superbly executed, were by passionate locals – including former Lismore City councillor Brian Henry - who had studied with nationally acclaimed cabinet maker and local resident Geoff Hannah.  Geoff’ latest masterpiece was in the show, while in a nearby room stood his million-dollar (literally) creation the ‘Hannah Cabinet’, the subject of an intensive fundraising effort aimed at keeping this wonderful work in Lismore.

Colin said he had trained with Geoff for one day a week for 16 years (Colin is now aged 31). The master had never raised his voice or expressed a cross word.

 In recent years breakthrough advances have occurred in the management of ischaemic stroke, greatly improving clinical outcomes. Along with the availability of clot retrieval for acute management of stroke there have been advances in stroke secondary prevention. The following article summarises the highlights of the talk given on the Modern Management of Stroke at the Nordoc conference in June 2019 and focuses on recent updates in the field.

Facts about stroke:

Stroke is one of Australia’s biggest killers and a leading cause of disability, killing more women than breast cancer and more men than prostate cancer (1). Even when patients survive, most suffer a disability that impedes their carrying out the activities of daily living unassisted (2). Therefore, it is of utmost importance to look for new ways and strategies to reduce the detrimental consequences of stoke.

Endovascular therapies:

One of the breakthrough advances has been the implementation of clot retrieval in the management of stroke caused by a large vessel occlusion. A series of clinical trials published in 2015 showed consistently that endovascular treatment, in combination with best practice medical treatment, was superior to the latter treatment alone for patients suffering acute occlusion of the internal carotid artery or the main stem of the proximal middle cerebral artery. The number needed to treat in most studies ranges between 3 to 7 to achieve a positive outcome and functional independence (3,4,5,6,7).

A study of mobile phone app usage by people with Type 2 Diabetes Mellitus (T2DM) has found that while recommended app usage improves self-management for most users only a minority of patients had practitioners involved in their app use. Further, all non-app users had never had the concept discussed with them by a health professional.

The findings of the study* were said to be “significant for GPs, nurse practitioners and allied health professionals who may integrate apps into a holistic management plan that considers strategies outside the clinical environment.”

The research team from Western Sydney University, The University of Sydney and the University Centre for Rural Health, Lismore (Dr Jane Barker and Dr Sabrina Pit) noted that better incorporation of user-centred features would enhance patient self-management, a significant factor in glycaemic control: “Self-management is considered the most important factor in ensuring well-controlled blood glucose levels (BGL) and, thereby, preventing diabetes complications. It has the potential to ease the burden on the healthcare system by encouraging patient autonomy and allowing disease monitoring outside clinical settings.”

Foetal alcohol spectrum disorder (FASD) is a lifelong condition where diffuse brain injury is caused by antenatal alcohol use. It is thought that the prevalence of foetal alcohol spectrum disorder may be as high of 2 - 4% of the Australian population. The majority of people with the disorder have not been diagnosed. They are, however, accessing their GP regularly as well as seeing other health professionals due to their multiple difficulties. The Australian diagnostic criteria for FASD are now available online.

GPs should consider FASD particularly in children, young people and young adults who have difficulties in multiple areas. People with FASD present with learning and language difficulties and they may have a present or past diagnosis of ADHD and/or Autism.