This month we spoke to Dr Rosy Dobrijevic, General Practitioner and Medical Director at the UQ Health Care St Lucia and Gatton Clinics.
What do you enjoy about your role as a GP providing healthcare to students?
The diversity of presentations, further enhanced by our multicultural cohort of students. Satisfaction even from the easiest scenarios of providing education and support to the more complicated cases where referral or other resources are needed to provide the best outcome for the students. Continue reading
When most of us get the flu, we spend three or four days on the couch feeling miserable, then we bounce back pretty quickly. But others have more severe symptoms and need to be hospitalised because they’re at risk of life-threatening complications. Some people even die from the flu.
The size and impact of influenza seasons varies from year to year. In 2017, Australia had its worst flu season for 20 years, with at least 1,255 lives lost. The 2018 season was relatively mild, but it doesn’t seem to have ever ended – cases have been reported throughout summer and into autumn 2019.
Protection often will have begun to wane four or five months later, so getting vaccinated in mid to late May, or even early June, will give you better protection at the height of the flu season. But there are number of factors to consider before deciding when to get your flu shot.
Remind me, why get a flu shot each year?
Influenza viruses change each year and the vaccine is updated to keep up with these changes. This year, for example, the vaccine protects against two different strains than the 2018 vaccine.
Our body’s immune response to the vaccine also wanes over time. So even if you were vaccinated last winter, you may no longer be fully protected 18 months later, depending on your age and your response to the last vaccination.
When does the flu vax become available?
Influenza vaccines are usually available in early April, or even in March; though you’ll generally have to pay full price for early access, even if you’re eligible for a free flu vaccine later.
In mid-April, stock starts arriving at GP clinics and pharmacies for the government’s immunisation program, which offers free flu vaccines for those most at risk of complications from influenza. This includes:
all Aboriginal and Torres Strait Islander people aged six months and over
pregnant women (during any stage of pregnancy)
all people aged 65 years and over
people aged six months and over with medical conditions which increase the risk of complications following influenza infections.
In addition, most states in Australia offer free vaccination to all other children from six months of age to five years of age.
For those not eligible for the free vaccine, influenza vaccines are available through pharmacies and GPs for between A$10 and A$25 (plus the cost of a consultation if your GP doesn’t bulk bill), or via workplace programs.
The 2018 flu season was mild but there have been more cases of influenza over summer than usual. kurhan/Shuttestock
Is it good to get in early?
Getting a vaccine immediately after it becomes available will ensure you don’t miss out if there’s a vaccine shortage. And it will protect against the “summer flus” we’ve been seeing over the last few months, which are circulating earlier than normal.
But there is a potential downside. Protection against influenza peaks one to two months after you have your vaccine, and then declines. This rate of decline varies from person to person, by age, and by influenza strain.
The flu season usually reaches its peak in August or sometimes even September. So if you’re vaccinated in early April, four to five months will have passed by the time you reach the peak virus months, and you will have lower levels of protection.
There are few good quality studies across all ages to measure this rate of decline accurately, although a study from 2015 showed that the measurable antibody responses to the influenza vaccine components reduced slowly.
Another study from 2014 showed the vaccine was less effective in people vaccinated three or more months earlier, adding to the evidence that protection wanes over time.
When is too late for the flu shot?
If you delay your decision to be vaccinated until July or August, when the flu season is well underway, your chance of becoming infected will significantly increase.
Mid to late May or early in June is the sweet spot between trying to maximise your protective levels of antibodies generated by vaccination and getting vaccinated before there are significant levels of influenza virus circulating.
Remember, it takes seven to ten days from the time of your flu shot for the vaccine to begin to be fully effective.
Getting vaccinated in late May or early June should provide good levels of protection during the peak of the influenza season and may even last through to November, by which time the influenza season has usually finished.
Vaccinate kids a month earlier
Vaccination timing is a little different for children. Those aged six months to nine years who haven’t been vaccinated against influenza before need two doses of vaccine, four weeks apart. So they will need to start their vaccination program a month earlier than adults and the elderly.
So if you want to get vaccinated in 2019, there’s no need to rush, and in fact May or even early June might be a better time to be vaccinated. But it’s better to be vaccinated early than not at all.
Professor Jeff Coombes and his research team are part of a $2 million international study to find out what type of exercise is best for brain health in older adults with memory problems.
“This will be the first direct comparison of three very different kinds of exercise to improve memory and thinking abilities in older adults,” Professor Coombes said.
“More than 500 people over the age of 60 will be recruited across Australia and Canada.
“We’re seeking people who are concerned about their memory or thinking abilities, but are able to complete daily activities independently.
“They will be randomly assigned to one of three different exercise groups: aerobic training, strength training, and balance and mobility training.”
Participants will exercise three times a week for 12 months under the supervision of an Accredited Exercise Physiologist.
They will also undergo assessments of their memory, physical function, body composition and blood vessel function.
Exercise sessions will last between 30 and 60 minutes, and will take place at research sites at Aveo in Durack, UQ Healthy Living in Toowong or UQ’s St Lucia campus.
Professor Coombes said volunteers in the trial would benefit greatly from taking part.
“This is a wonderful opportunity to get a free personal trainer for a year and at the same time contribute to understanding more about what type of exercise is best for the brain.”
We spoke with Clinical Psychologist Dr Frank Walsh, based at the UQ Health Care Gatton Clinic about tips students can use to find more clarity, calm and focus during the semester and leading up to exams.
Study effectively
Reduce anxiety by being well prepared.
Spread your studying over the whole term rather than “cramming.” Feeling that you don’t have enough time to cover everything increases anxiety.
Study in 50 minute blocks with 10 minute activity or nutrition breaks.
Learn memory enhancement techniques.
Study by getting comfortable with what you will have to do in the exam: writing answers to practice questions under a time limit while sitting at a desk.
Prepare to write the exam
Eliminate extraneous sources of anxiety such as how to get to the exam room by figuring that out in advance.
Think about what commonly distracts you during exams (e.g.: frequent clock-watching, noise from other students etc.) and develop strategies in advance for dealing with these distractions.
Get as much rest as possible the night before the exam.
Wear a watch to monitor your time.
Wear layered clothing so you can control your temperature during the exam.
Only go to the exam room a few minutes early to avoid encountering anxious people.
Adjust your attitude
Maintain an attitude of doing the best you can under the circumstances, rather than requiring perfection from yourself.
Plan a reward for yourself after the exam. Praise yourself as you write the exam; e.g.,“half done and so far, so good.”
Change unhelpful thoughts
Learn, and practice over time, how to challenge your negative thoughts (e.g., “I’m going to fail.”).
The best way to do this is to let the negative thought be true until your mind rejects it i.e. focus on the negative thought, and only one negative thought at a time, and wait until you become bored with it.
Use test-taking strategies
Do a “memory dump” of information you are afraid you will forget on the back of the exam when you first receive it.
Read through the exam at the beginning and figure out how much time to spend on each question, according to what each question is worth.
To build confidence, start with questions you know rather than focusing on the ones you don’t.
Start with any multiple-choice or True/False section to gain clues that might help you answer other questions.
Take 30-second “mini-breaks” at specified points during the exam to use a relaxation strategy such as closing your eyes, relaxing your hands, and breathing deeply.
If your thoughts are racing and your mind becomes cluttered with worries
Don’t focus on getting rid of the anxiety because that will only feed the anxiety;
Concentrate hard on a specific sensation (e.g the hum of the lights in the room) to clear your mind of anxiety; or
Be with your anxiety – concentrate on your physical symptoms. If you can completely experience a physical sensation, it often disappears.
When these don’t work for you
There are some students who experience very intense anxiety in spite of following all of these steps. If you are one of these students then you may benefit from more intensive psychological assistance through one-on-one sessions with a clinical psychologist who can guide you through better managing the anxiety you experience.
Find out more or book an appointment with a clinical psychologist at a UQ Health Care Clinic.
This month we spoke to Steve Royle, Exercise Physiologist at the UQ Health Care Ipswich Bremer Medical Centre.
What have been your highlights whilst working at the Bremer Medical Centre? Meeting and assisting so many great members of the Ipswich and Somerset Regional communities in the past three years suffering from one or more chronic health conditions to better self-manage their health with exercise and physical activity.
Assisting UQ Health Care to co-ordinate and facilitate seven falls prevention programs across the Ipswich and Somerset region in 2015 which saw 105 people attend these programs over the eight week period.
Building my type 2 diabetes group services from one class offered weekly to five in the past year and educating many Ipswich GP’s and nurses on the benefits of group services for type 2 diabetes.
What does a typical day look like for you? I provide a number of group exercise classes weekly for different medical conditions injuries and individual consults for Medicare and DVA referrals as well as private paying customers.
What aspects of your role in providing healthcare for older people do you enjoy the most? Showing them how to fit exercise and physical activity into their daily life around their other commitments which makes it more manageable and achievable for them.
Being able to work with a person to empower them to improve self-management and their quality of life.
Breaking down the stereotype that they are “too old” to be active or exercise!
Why is exercise physiology important for healthy ageing? Exercise is medicine! We are the best allied health professional to provide guidance in this area as we utilise exercise as our primary method of treatment to manage and prevent chronic injuries and health issues.
Exercise is one of the cheapest forms of treatment/ management available. A recent report found that for every $1 spent on exercise physiology interventions the average person saved $10.50 over the course of the year (or a net benefit of $5,938 yearly).
Exercise and physical activity can be used to manage a wide variety of health issues. Nine out of nine recent health priority areas identified by the Australian government have large amounts of quality evidence to suggest supervised and professionally prescribed exercise is effective in their management.
What results have you seen with your older clients? Goals and results vary so much depending on the person and why they are being referred however some of the more common ones include – improved self-confidence, improved quality of life, improved self-management of health conditions and reduced symptoms related to health conditions.
Travelling overseas over your uni break? Have you booked in for your immunisations? Registered nurse Jo-Ann Hoban based at the UQ Health Care Gatton Clinic shares what you need to know about travel vaccines.
If you travel outside Australia, you may get sick from a number of diseases that are preventable by vaccination. Different vaccines are needed for certain countries. There is no standard immunisation schedule that will suit all travellers. The recommended vaccines for travelling depend on a number of factors. These include your age, pregnancy or planning pregnancy, underlying medical conditions, vaccination history, location and season of travel.
You should book an appointment at a UQ Health Care Clinic six to 12 weeks before you leave Australia. It is important that you don’t wait until the last minute to visit your doctor to discuss what vaccines you need for your trip. You might need a number of doses of a particular vaccine and you might need time after immunisation for your body to develop full immunity.
Even if you have been vaccinated for certain diseases in the past, you should still check with your doctor or travel health clinic. Your immunity to some diseases may have changed or reduced with time and you may need a booster. Also, depending on your age and where you were born, you may not be protected against some diseases.
Travel is an important time to check whether you are up to date with your vaccinations. These can be routine childhood vaccinations and boosters. Some of these include measles-mumps-rubella (MMR), diphtheria-tetanus-whooping cough (pertussis), polio, chickenpox (varicella) and influenza. The chance of getting these diseases may be greater while travelling overseas. These diseases can be brought into Australia by travellers and lead to disease outbreaks.
Travel vaccines that may be required include hepatitis, typhoid, meningococcal, rabies, Japanese encephalitis, yellow fever* and cholera.
Find out more or book an appointment at a UQ Health Care Clinic. Remember to bring in a copy of all your previous vaccines if possible, both childhood and travel related and an itinerary, so the correct vaccines can be determined.
*Please note the yellow fever vaccine is only available at the St Lucia and Annerley clinics.
This month we spoke to Dr Rosy , General Practitioner and Medical Director at the UQ Health Care St Lucia and Gatton Clinics
What do you enjoy about your role as a GP providing health care to students? The diversity of presentations, further enhanced by our multicultural cohort of students. Satisfaction even from the easiest scenarios of providing education and support to the more complicated cases where referral or other resources are needed to provide the best outcome for the students.
What challenges do GPs currently face working in student health? Increasing demands being placed on students – financial and academic pressures with subsequent stress related presentations.
Can you suggest any solutions for these? Currently there is increasing community concern about how people, especially the younger age group, cope with stress and the related negative mental health outcomes. With this increasing concern comes improved insight, recognition, support and resources.
How do students benefit from having GPs available on campus? Students benefit from having an easily accessible, ‘free’ health service which provides comprehensive care, including access to our visiting mental health team, travel medicine, antenatal and paediatric care, provision of course related and catch up immunisations, contraception (including Implanon and IUDs) and sexual health, to name a few.
How important do you think it is to have these services available on campus? Essential, as we are accessible and provide a free service, with no out of pocket costs for most consultations/procedures. For most students who are time poor and have financial constraints, a service on campus plays a major role in their health care. In addition our triage system caters for those who present acutely ill with assessment undertaken by our Registered Nurses, then GP consultation if needed.
This month we spoke Dr Elizabeth Justo, UQ Health Care General Practitioner at Aveo Durack.
What inspired you to pursue a career? I started off in paediatrics, but transitioned to general practice to fit with my growing family’s needs
What have been your highlights whilst working at AVEO Durack? The relationships I have developed with patients, and their families, with co-workers in every capacity from nursing staff, carers, village staff, and my medical colleagues who continue to amaze and inspire me with their dedication and skill. I have learnt much of life from my relationships at Aveo.
What does a typical day look like for you? A typical day is a cup of coffee, a big breath, then running/juggling consulting room and treatment room and emergency walk-ins. I am often apologising for a long waiting time to a smiling patient and an overflowing waiting room. More coffee, biscuits dropped in from wonderful patients, computer paperwork and then house calls around the community for those too frail/unwell to come to the surgery.
What aspects of your role in providing health care for older people do you enjoy the most? It is a privilege to do this work with the aged, to become involved in their lives, getting to know them as people not just their illnesses, to know their families, their contribution to Australia and their community, and to care for them professionally at this very vulnerable time of life. They are deserving of the very best of care and support. The wisdom, the humour, appreciation and love they give back is what it is all about.
What are your interests outside of work? I have a very busy and dedicated husband and three gorgeous sons, as well as a very strong extended family. I love reading, walking, and our labrador and look forward to having more time one day to learn bridge and travel.
Homelessness increased by 14 percent between the 2011 and 2016 censuses, with over 116,420 people now thought to have no permanent home in Australia.
The rate of homeless men increased from 54 to 58 per 10,000, according to the data released by the Australian Bureau of Statistics in March this year.
There is considerable research to suggest an overlap between people experiencing precarious housing, and drug and alcohol misuse, that has created an increased need for a partnered approach to homelessness and addiction services.
UQ Health Care Clinical Lead in homelessness and addiction medicine, Dr Nancy Sturman, manages general practice support for the Ozcare Men’s Homeless Hostel and the Ozcare Integrated Drug Treatment Unit.
“I work in collaboration with Ozcare nurses, case workers, and other health professionals from Queensland Health, Mater Public Hospital and non-government organisations to provide general practice care.
“We provide care that addresses clients’ priorities, takes a trauma-informed approach, helps minimise the harms of substance use, links clients to other outreach supports, hospital-based treatment and counselling, and includes regular general practice care.”
Dr Sturman has 28 years experience as a general practitioner and a special interest in mental health issues and substance use disorders.
“My clients are often very generous with their thanks and positive feedback and appreciate the care.
“In times of trouble any success can be important, such as the clearance of Hepatitis C infection with treatment. These successes can increase self-belief and optimism about the future.
“I am often inspired by our clients, as many of the men I treat have a lot of resilience and courage despite years of experiencing accumulated trauma and pain, and significant mental health and health literacy issues.”
The Ozcare Integrated Drug Treatment Unit is a service that homeless men with alcohol or drugs problem can access and receive treatment via live-in detox programs and recovery services.
UQ Health Care Chief Executive Officer Darryl Grundy said the general practice support Dr Sturman delivers to homeless men is an important function of UQ Health Care.
“Dr Sturman and the team are highly regarded health professionals who play a significant role in supporting homeless men in Brisbane with their physical and mental health and addiction issues they face,” Mr Grundy said.
“These organisations are vital to provide health and social support to people experiencing homelessness.”
UQ Healthy Living welcomed Five Good Friends ambassador and positive ageing advocate Ita Buttrose AO OBE to its Toowong premises this week, to share how its integrated health and lifestyle programs are transforming Brisbane’s over 50s.
As a legendary media trailblazer, businesswoman, best-selling author, community and welfare contributor and 2013 Australian of the Year, Ms Buttrose’ name has become synonymous with successful ageing.
Before touring UQHL facilities, Ms Buttrose spoke on behalf of home care provider Five Good Friends at the ‘CHAT Speaker Series’ about the importance of maintaining fitness and sociability.
“Not enough (health professionals) recommend the need to improve balance through exercise to prevent falls,” Ms Buttrose said.
“I believe improving balance is a really neglected area of improving seniors’ health.”
Clinical Director and physiotherapist Simon Whitehart introduced Ms Buttrose to seniors engaging in exercise programs designed to improve specific vulnerabilities, like poor balance and strength, while on the UQHL tour.
“We’re excited to share with Five Good Friends how our programs work and introduce Ita to some of the people who have had their lives transformed since joining our community,” Mr Whitehart said.
The clinic, developed by The University of Queensland and UQ Health Care, promotes healthy ageing and wellbeing in older adults by providing assessments and interventions in exercise, diet and lifestyle.
“We want to help our clients remain as healthy, active and independent as they can be.”
Clinical educators such as Mr Whitehart are leaders in their field and closely guide UQ students as they contribute to the patient journey.
Treatment is informed by the latest research as students bring new teachings and innovation to the front line of healthcare.
Bringing together services in dietetics, exercise and sports science, clinical exercise physiology, nursing, pharmacy, physiotherapy and psychology, patients can access individual consults and small group activities as part of their tailored plan.
