Night’s Watchmans and the White Walkers - Game of Thrones

"... and winter is coming" are the ominous words first uttered by Eddard Stark, Lord of Winterfell and Warden of the North, in the opening scenes of Game of Thrones. Such words were well heeded by Napoleon in Russia in 1812, if not by Hitler in 1941, and now, in a similarly invasive, if less violent, context, by health custodians of the NSW Far North Coast in 2017.

The Northern NSW Local Health District (NNSW LHD), in conjunction with the North Coast Primary Health Network, local Aboriginal Medical Services and General Practices, is on a quest before this year’s winter sets in.

Each April/May sees a spike in patients attending general practices to receive influenza, pneumonia and other vaccines. Many practices attempt to cope with this increased load by running clinics for their most susceptible patients. Most Aboriginal people and all people aged over 65 qualify for free vaccinations.

Dr Richard Buss

In a situation said to be replicated across NSW, clinical communications between the public health system and general practice about mental health patients/clients is less than ideal.

However, the various shortcomings, including systemic issues, have now been identified, and a range of steps is being taken, or planned, in order to provide continuous care for both acute patients and those in the community setting.

This is the message to GPs from the Director of Mental Services for the Northern NSW Local Health District, Dr Richard Buss, who discussed the situation with GP Speak recently.

Maddy Braddon and Lorraine Tasker from Helping Hands  Lismore

According to many people affected by Lismore’s catastrophic flooding on 31 March, as well as others with long-time memories of local flood events, it wasn’t the 1-in-10 year levee bank that let the city down.

Rather, they say, it was the various tiers of officialdom that should have provided more consistent information about the chances of inundation and a timetable for remedial measures such as saving home and business contents, and an orderly evacuation.

As it happened, the previously unbreached levee looked increasingly likely to over-top, yet many residents and businesses were still being told the flooding would probably be minor, and the levee would repel the floodwaters.

Last year's gaming sensation, Overwatch, and Czech born mathematician, Johann Karl August Radon, have both contributed to improving breast Imaging on the North Coast of New South Wales.

Digital breast tomosynthesis generates three dimensional images of the breast using the same principles as those used in the past for intravenous pyelograms. Modern radiology equipment can reconstruct an image of the breast in seconds, which allows the radiologist to hone in on areas of interest and get a clearer view of possible lesions. Such lesions, obscured by overlapping breast tissue, may not have been detected on 2D mammography.

The high speed of the image rendering combined with the better spatial orientation also enables accurate placement of localisation wires for excision biopsy of putative lesions.

On 4 May, following an identified spike in cases of whooping cough, the North Coast Public Health Unit issued an ‘Urgent vaccination plea’ urging parents to immunise their children against preventable diseases.

Acting Director of Public Health, Greg Bell, said there had been 37 whooping cough notifications in the previous week, more than double that of the previous week.

“Anyone can contract whooping cough, it spreads easily by sneezing and coughing, and can be a life threatening infection for infants,” Mr Bell said.

Public health units actively follow up all cases involving children under five years of age by attempting to contact parents by phone. For those cases involving patients older than five years, the PHU sends either an SMS or letter in an attempt to provide all cases with information relating to whooping cough in a timely manner.