- Written by Dr Sarah Coghill, ID physician.Lismore
Prior to the widespread development and use of antibiotics, some bacterial infections, such as bacterial endocarditis and meningitis, were almost uniformly fatal. The leading causes of death in 1900 were infections: pneumonia, TB and diarrhoea/enteritis. While sulphur antibiotics were developed first, the discovery of penicillin in 1928 lead to its widespread use by the 1940’s, resulting in a significant change in epidemiology of disease throughout the 20th century with a sharp drop in infant and child mortality and a near 30 year increase in life expectancy by the late 1990’s.
Resistance to antibiotics has occurred for every antibiotic agent that has ever been used. Antibiotic resistance is not a man-made phenomenon but rather a reflection of natural selection and evolution; widespread antibiotic use, however has led to the rapid emergence of resistance bacteria.
- Written by Robin Osborne
As a lay attendee (one of only two) at the NoRDocs Unconference I am in no position to comment on the clinical veracity of the presentations delivered in the packed six hours that it ran.
As the presenters were acknowledged experts in their diverse fields, I can only assume that they spoke with authority and made significant contributions to the knowledge base of the audience, including us two ‘NCAs’ who, perhaps surprisingly, found most of the sessions understandable.
Certainly, the reception that all speakers received was extremely positive.
The frustration, of course, was how to resolve the dilemma facing all ‘festival’ goers - would one prefer ‘Tom Keneally in conversation’ or ‘Gareth Evans with Kerry O’Brien’? (examples from this year’s Byron Writer’s festival) . Or in the Unconference, GP Dr Zewlan Moor from Byron Bibliotherapy on the healing power of reading, or neurologist Dr Bob Lodge on the timely topic of cannabis in medicine, and how Australia has been slow to address the relevant issues?
- Written by Dr Chris Ingall
Wine is made to be drunk with food, its taste and structure perfectly complementing and enhancing the eating experience and ingestion, as well as the process of digestion.
The pairing also dictates a measure of moderation, as the drinking stops (or should) when the last bite is taken. A marriage made in heaven, and something you can optimise at home, matching the type of food to the age and variety of wine (particularly if you have invested in a cellar).
Other alcoholic drinks don’t come close, as the flavour profiles of beer and cider are much more limited, and fortified wines and spirits are overpowering in their pace of inebriation, which to me takes away from, rather than adds to, the experience of sharing a meal.
- Written by By Bronwyn Hemsley, PhD. Professor of Speech Pathology at the University of Technology Sydney
With funding from the National Health and Medical Research Council of Australia, we’ve been conducting research on the My Health Record. To understand more about one of the documents within the record, we recently reviewed the legal and ethical issues surrounding Advance Care Directives in Australia, and considered implications for storage in the My Health Record (see McCarthy et al., 2017).
There are many legal and ethical issues relating to Advance Care Planning and Advance Care Directives in Australia, and both doctors and patients navigate complex legal issues relating to legal capacity to make decisions, and either create or identify the validity of Advanced Care Directives. Advance Care Planning holds opportunities and benefits for those who engage with the process, and an Advance Care Directive gives individuals the chance to determine the care they will receive in the future, when they are no longer able to express those wishes.
A recently published paper shows that boosting self-efficacy - defined by psychologist Albert Bandura as “one's belief in one's ability to succeed in specific situations or accomplish a task” - can reduce the impact of social isolation experienced by one-third of students undertaking rural placements.
The subjective feeling of social isolation can be defined as a sense of not belonging to a community or geographical area. Studies suggest that perceived social isolation contributes to depressive thoughts and/or distress, and renders medical students less likely to pursue a rural career after graduation.
However, social isolation can be addressed through enhancing the attribute Bandura said plays “a major role in how one approaches goals, tasks, and challenges.”
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