Shows
Pomegranate HealthEp128: Brushing off the cobwebsThere is evidence that six months or more off the job leads to some loss of practical skills and knowledge and certainly, many doctors a loss of self-confidence. People take time out from medical practice for many different reasons but career breaks to raise children are more common than ever before. Paediatrics is one specialty where female representation exceeds 70 percent and it is also becoming more common for new fathers to take leave as primary carers. Senior staff at Sydney Children’s Hospital have developed a day-long workshop to help medics brush off the cobwebs before they return to pr...2025-05-0131 min
Yoga Medicine133 Yoga & Rheumatoid Arthritis: Expert Insights with Dr Nikki Tugnet FRACPToday host Rachel dives deep into Rheumatoid Arthritis (RA) with returning guest Dr. Nikki Tugnet FRACP. We discuss common symptoms, what distinguishes RA from other inflammatory and auto-immune conditions, the role Western medicine can play, and – most importantly – how yoga can help. Listen in to learn how yoga teachers best serve students with RA, how to sneak more mindfulness and body awareness into your classes, and the vital importance of making space for rest. — Show Notes: The background on rheumatoid arthritis (RA) [2:22] Common symptoms [10:50] Uncontrolled RA versus remission [14:32] Western medical interventions [16:00] How yoga c...2025-04-1055 min
Pomegranate HealthEp126: Trying times for Māori medicsIn Aotearoa-New Zealand, the proportion of doctors identifying as Māori has doubled from where it was a decade ago to over 5 percent. But there is still a long way to go before the workforce is representative of the broader population which is 17 percent Māori.The Auckland and Otago Medical Schools have in recent years turbocharged their intake of Māori and Pasifika students but these graduates don’t seem to have trickled through to the RACP in great numbers. Just 3.5 percent of general physicians and 4.8 percent of paediatricians identify as Māori, and Pasifika doctors make u...2025-03-2745 min
Pomegranate HealthEp124: Pleural medicine comes of ageProfessor Gary Lee established the first dedicated pleural service in the southern hemisphere in 2009, at the Sir Charles Gairdner Hospital in Perth. He says that pleural disease has finally come to be regarded as an area of subspeciality interest in its own right, not just a complication of other comorbidities. In this podcast he presents a potted history of key developments in the management of pleural effusion in particular. This is diagnosed in about 60,000 people every year in Australia, mainly as a result of infection or malignancy. With mentors in the UK, Professor Lee conducted some of t...2025-02-2757 min
Pomegranate Health[Journal Club] Thrombolysis up to 24hr after ischaemic strokeThrombectomy for acute ischaemic stroke has undergone great advances in the last decade, but the expertise and technology is restricted to tertiary hospitals. Outside of large metropolitan centres, thrombolytic treatment can buy a patient time, but for almost 30 years the first line agent has remained unchanged. Alteplase is an analog of the human tissue plasminogen activator which activates plasmin to dissolve fibrin blood clots. For many years it was assumed that alteplase should be administered within 3 hours of symptom onset, thus it was a big deal when in 2008, research showed that that window could be safely broadened o...2024-10-2543 min
Pomegranate Health[IMJ On-Air] Understanding readmissions betterThe LACE index is a prognostic algorithm for predicting the likelihood that a newly discharged patient will come back into hospital within 30 days because of complications. Today’s IMJ paper describes a validation of the LACE index in a regional Victorian setting. Identifying patients who are at risk could allow for better targeted care at the first admission, reducing harm to patients and inefficient use of healthcare resources. The researchers also tested a novel classification tool for scoring which readmissions are avoidable and which are just an unfortunate outcome of the patient’s illness. This could help more a...2024-08-2230 min
Pomegranate Health[CPD On Demand] Advance Your CPD Through Effective SupervisionFrom 2024, supervising has been recognised as a Category 2 CPD activity. This short and insightful episode focuses on recent updates to the 2024 MyCPD Framework, highlighting the recognition of supervisory activities as a critical element of Category 2 Reviewing Performance CPD. Please join Professor Martin Veysey, a renowned expert in supervision and medical education, and Associate Professor Kudzai Kanhutu, College Dean, as they delve into the practicalities and strategic benefits of integrating supervision into your CPD activities. This podcast offers guidance on planning and recording supervising activities, using MyCPD tools to streamline the process efficiently.Guests2024-07-1615 min
OPENPediatricsPICU Podcasts: Behind the Mic by T. Wolbrink et al | OPENPediatricsIn this World Shared Practice Forum podcast, PICU podcasters share their insights on how to get started and deliver successful podcasts. Key points include strategies for finding co-hosts and guests, ways to promote podcasts, and the importance of finding ways to incorporate podcasts into academic CVs.
LEARNING OBJECTIVES
Following this discussion, learners will be able to:
- Discuss strategies to identify podcast co-hosts and guests
- Describe ways that podcasts can be shared with potential listeners
- Compose an academic CV that includes podcasts and appropriate metrics
AUTHORS
Peta Alexander, MBBS, FRACP, FCICM
Senior Associate Cardiologist, Department of Cardiology
Boston Ch...2024-06-1747 min
Pomegranate HealthEp109: Cultivating a rural workforceAustralia is a big continent and sparsely populated continent. 28 percent of Australians live in areas classified regional, rural or remote and their access to health services is much more limited. It’s estimated that between 2009 and 2011 there were 19,000 excess deaths in regional and remote areas as compared to the major cities. No doubt, socioeconomic disadvantage is factor in that mortality gap, but inequitable access to healthcare is also a major driver. In this podcast we focus specifically on the shortage in health practitioners in the regions. Even in regional centres, the density of physicians by pop...2024-06-1145 min
PeerVoice Internal Medicine VideoMaria Craig, MBBS, PhD, FRACP, MMed(ClinEpid) - Treating T2D in People of Younger Age in This Day and Age: How Would You Manage These Children and Adolescents With T2D?Maria Craig, MBBS, PhD, FRACP, MMed(ClinEpid) - Treating T2D in People of Younger Age in This Day and Age: How Would You Manage These Children and Adolescents With T2D?2024-05-2247 min
PeerVoice Endocrinology & Metabolic Disorders AudioMaria Craig, MBBS, PhD, FRACP, MMed(ClinEpid) - Treating T2D in People of Younger Age in This Day and Age: How Would You Manage These Children and Adolescents With T2D?Maria Craig, MBBS, PhD, FRACP, MMed(ClinEpid) - Treating T2D in People of Younger Age in This Day and Age: How Would You Manage These Children and Adolescents With T2D?2024-05-2247 min
PeerVoice Endocrinology & Metabolic Disorders VideoMaria Craig, MBBS, PhD, FRACP, MMed(ClinEpid) - Treating T2D in People of Younger Age in This Day and Age: How Would You Manage These Children and Adolescents With T2D?Maria Craig, MBBS, PhD, FRACP, MMed(ClinEpid) - Treating T2D in People of Younger Age in This Day and Age: How Would You Manage These Children and Adolescents With T2D?2024-05-2247 min
PeerVoice Internal Medicine AudioMaria Craig, MBBS, PhD, FRACP, MMed(ClinEpid) - Treating T2D in People of Younger Age in This Day and Age: How Would You Manage These Children and Adolescents With T2D?Maria Craig, MBBS, PhD, FRACP, MMed(ClinEpid) - Treating T2D in People of Younger Age in This Day and Age: How Would You Manage These Children and Adolescents With T2D?2024-05-2247 min
The Yoga RheumEp 22. Dr. Nikki Tugnet, MD, FRACP - Where Yoga and Rheumatology MeetDr Nikki Tugnet MD, FRACP is a Rheumatologist in clinical practice in Auckland, New Zealand, an RYT®500 yoga teacher and a Yoga Medicine® Therapeutic Specialist. She specializes in working one-to-one with people with various forms of autoimmune disease and arthritis, providing online Yoga for Autoimmunity and arthritis.Her clinical research interest is in Systemic Lupus (SLE) and she is an investigator for one of the world's largest lupus research groups, the Asia-Pacific Lupus Collaboration (APLC).Nikki integrates yoga therapeutics within her medical practice, providing whole person healthcare. She is passionate about sharing the health system of yoga so that pe...2024-05-031h 00OPENPediatricsThe Sound of Knowledge: Popular PICU Podcasts Today by T. Wolbrink et al | OPENPediatricsIn this World Shared Practice Forum podcast, we will explore the role of podcasts for learning and discuss the most popular pediatric critical care podcasts from across the world. Drs. Peta Alexander, Erin Bennett, Rahul Damania, Patrick Davies, Zachary Hodges, Greg Kelly, Elizabeth Mack, and Alice Shanklin will describe their podcast series and explore how podcasts have impacted pediatric critical care education.
LEARNING OBJECTIVES
Upon listening to this presentation, learners will be able to:
- Identify the potential benefits of listening to podcasts for learning.
- Describe and contrast the most popular pediatric critical care podcasts today.
AUTHORS
Peta Alexander...2024-04-1947 min
PeerVoice Oncology & Haematology AudioJeffrey Szer, MBBS, FRACP - The Quest for Optimal Haemolytic Control of Paroxysmal Nocturnal HaemoglobinuriaJeffrey Szer, MBBS, FRACP - The Quest for Optimal Haemolytic Control of Paroxysmal Nocturnal Haemoglobinuria2024-04-1819 min
PeerVoice Oncology & Haematology VideoJeffrey Szer, MBBS, FRACP - The Quest for Optimal Haemolytic Control of Paroxysmal Nocturnal HaemoglobinuriaJeffrey Szer, MBBS, FRACP - The Quest for Optimal Haemolytic Control of Paroxysmal Nocturnal Haemoglobinuria2024-04-1819 minPeerVoice Internal Medicine AudioJeffrey Szer, MBBS, FRACP - The Quest for Optimal Haemolytic Control of Paroxysmal Nocturnal HaemoglobinuriaJeffrey Szer, MBBS, FRACP - The Quest for Optimal Haemolytic Control of Paroxysmal Nocturnal Haemoglobinuria2024-04-1819 minPeerVoice Internal Medicine VideoJeffrey Szer, MBBS, FRACP - The Quest for Optimal Haemolytic Control of Paroxysmal Nocturnal HaemoglobinuriaJeffrey Szer, MBBS, FRACP - The Quest for Optimal Haemolytic Control of Paroxysmal Nocturnal Haemoglobinuria2024-04-1819 min
Pomegranate Health[Journal Club] Baricitinib immune therapy for new onset type 1 diabetesType 1 diabetes has a very high treatment burden in terms of direct costs, inconvenience and lost productivity for patients and their carers. Further, all the glucose checking, hormone replacement and consults don’t abolish the vascular complications associated with poor glycaemic control. Only in the last few years has it been possible to pharmacologically alter the course of type 1 diabetes and other auto-immune diseases without generating intolerable side effects.Teplizumab is an antibody to CD3 which was presented to the world in 2019 as delaying the onset of type 1 diabetes in high-risk individuals thanks to its protective effect on...2024-04-1140 min
Pomegranate HealthEp105: When parents and paediatrics clashLast November an NHS Hospital Trust in Nottingham sought permission from the UK High Court to withdraw life support from a seven-month old girl called Indi Gregory. The devastated parents did not want to give up on her although they were advised there was no hope of treatment for her profound developmental disability. The family and the medical teams returned to court two more times, right up to the day that Indi was to be extubated. Conflicts over care have always existed but their frequency has increased as medicinal advances present more options for intervention even in t...2024-02-2749 min
PeerView Oncology & Hematology CME/CNE/CPE Video PodcastProfessor Benjamin Solomon, MBBS, PhD, FRACP, FAHMS - Adapting Our Strategies for Decision-Making in Testing and Treatment of RET-Altered Lung and Thyroid Cancers: A Personalized Learning JourneyThis content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/CC/NCPD/CPE/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/ANR865. CME/MOC/CC/NCPD/CPE/AAPA/IPCE credit will be available until January 16, 2025.Adapting Our Strategies for Decision-Making in Testing and Treatment of RET-Altered Lung and Thyroid Cancers: A Personalized Learning Journey In support...2024-02-011h 25
PeerView Clinical Pharmacology CME/CNE/CPE Audio PodcastProfessor Benjamin Solomon, MBBS, PhD, FRACP, FAHMS - Adapting Our Strategies for Decision-Making in Testing and Treatment of RET-Altered Lung and Thyroid Cancers: A Personalized Learning JourneyThis content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/CC/NCPD/CPE/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/ANR865. CME/MOC/CC/NCPD/CPE/AAPA/IPCE credit will be available until January 16, 2025.Adapting Our Strategies for Decision-Making in Testing and Treatment of RET-Altered Lung and Thyroid Cancers: A Personalized Learning Journey In support...2024-02-011h 25
PeerView Internal Medicine CME/CNE/CPE Audio PodcastProfessor Benjamin Solomon, MBBS, PhD, FRACP, FAHMS - Adapting Our Strategies for Decision-Making in Testing and Treatment of RET-Altered Lung and Thyroid Cancers: A Personalized Learning JourneyThis content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/CC/NCPD/CPE/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/ANR865. CME/MOC/CC/NCPD/CPE/AAPA/IPCE credit will be available until January 16, 2025.Adapting Our Strategies for Decision-Making in Testing and Treatment of RET-Altered Lung and Thyroid Cancers: A Personalized Learning Journey In support...2024-02-011h 25
PeerView Heart, Lung & Blood CME/CNE/CPE Video PodcastProfessor Benjamin Solomon, MBBS, PhD, FRACP, FAHMS - Adapting Our Strategies for Decision-Making in Testing and Treatment of RET-Altered Lung and Thyroid Cancers: A Personalized Learning JourneyThis content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/CC/NCPD/CPE/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/ANR865. CME/MOC/CC/NCPD/CPE/AAPA/IPCE credit will be available until January 16, 2025.Adapting Our Strategies for Decision-Making in Testing and Treatment of RET-Altered Lung and Thyroid Cancers: A Personalized Learning Journey In support...2024-02-011h 25
PeerView Heart, Lung & Blood CME/CNE/CPE Audio PodcastProfessor Benjamin Solomon, MBBS, PhD, FRACP, FAHMS - Adapting Our Strategies for Decision-Making in Testing and Treatment of RET-Altered Lung and Thyroid Cancers: A Personalized Learning JourneyThis content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/CC/NCPD/CPE/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/ANR865. CME/MOC/CC/NCPD/CPE/AAPA/IPCE credit will be available until January 16, 2025.Adapting Our Strategies for Decision-Making in Testing and Treatment of RET-Altered Lung and Thyroid Cancers: A Personalized Learning Journey In support...2024-02-011h 25
PeerView Internal Medicine CME/CNE/CPE Video PodcastProfessor Benjamin Solomon, MBBS, PhD, FRACP, FAHMS - Adapting Our Strategies for Decision-Making in Testing and Treatment of RET-Altered Lung and Thyroid Cancers: A Personalized Learning JourneyThis content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/CC/NCPD/CPE/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/ANR865. CME/MOC/CC/NCPD/CPE/AAPA/IPCE credit will be available until January 16, 2025.Adapting Our Strategies for Decision-Making in Testing and Treatment of RET-Altered Lung and Thyroid Cancers: A Personalized Learning Journey In support...2024-02-011h 25
PeerView Clinical Pharmacology CME/CNE/CPE VideoProfessor Benjamin Solomon, MBBS, PhD, FRACP, FAHMS - Adapting Our Strategies for Decision-Making in Testing and Treatment of RET-Altered Lung and Thyroid Cancers: A Personalized Learning JourneyThis content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/CC/NCPD/CPE/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/ANR865. CME/MOC/CC/NCPD/CPE/AAPA/IPCE credit will be available until January 16, 2025.Adapting Our Strategies for Decision-Making in Testing and Treatment of RET-Altered Lung and Thyroid Cancers: A Personalized Learning Journey In support...2024-02-011h 25
PeerView Oncology & Hematology CME/CNE/CPE Audio PodcastProfessor Benjamin Solomon, MBBS, PhD, FRACP, FAHMS - Adapting Our Strategies for Decision-Making in Testing and Treatment of RET-Altered Lung and Thyroid Cancers: A Personalized Learning JourneyThis content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/CC/NCPD/CPE/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/ANR865. CME/MOC/CC/NCPD/CPE/AAPA/IPCE credit will be available until January 16, 2025.Adapting Our Strategies for Decision-Making in Testing and Treatment of RET-Altered Lung and Thyroid Cancers: A Personalized Learning Journey In support...2024-02-011h 25
PeerView Endocrinology & Diabetes CME/CNE/CPE Audio PodcastProfessor Benjamin Solomon, MBBS, PhD, FRACP, FAHMS - Adapting Our Strategies for Decision-Making in Testing and Treatment of RET-Altered Lung and Thyroid Cancers: A Personalized Learning JourneyThis content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/CC/NCPD/CPE/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/ANR865. CME/MOC/CC/NCPD/CPE/AAPA/IPCE credit will be available until January 16, 2025.Adapting Our Strategies for Decision-Making in Testing and Treatment of RET-Altered Lung and Thyroid Cancers: A Personalized Learning Journey In support...2024-02-011h 25
Pomegranate Health[IMJ On-Air] Is the jury still out on omega-3 supplementation?The theory that certain fatty acids are essential to the diet and associated with reduced cardiovascular risk has been controversial since it was floated in the 1950s. In 1971 Danish researchers published the results from a cross-sectional study of Inuit people living on the west coast of Greenland. They ate a fish-based diet rich in polyunsaturated fatty acids known as omega-3s, which were found in their tissues along with much lower levels of pre-β-lipoprotein and plasma-triglycerides when compared to controls. That association between a fishy diet and lowered cardiovascular risk has been replicated in mult...2024-01-3125 min
Pomegranate Health[IMJ On-Air] HepatoCare: a model for palliative and supportive care in advanced cirrhosisMedian survival for patients diagnosed with advanced cirrhosis is around 2 years and quality of life is poor. Fewer than a quarter of such patients receive referrals to palliative care and advanced care plans are also rare. Existing research from abroad suggests that hepatology staff aren’t familiar with referral criteria and assume that palliative services become involved only at the very end of life. To try and reduce barriers to referral, clinicians at Royal Brisbane Hospital developed a model called Hepatocare. They adapted a palliative care referral algorithm to include cirrhosis specific markers and continuity of care betw...2023-12-1139 min
Pomegranate HealthEp102: Staying on script with semaglutideSemaglutide, branded as Ozempic or Wegovy, is an analogue of glucagon-like peptide 1 which has glucose-dependent effects on insulin secretion. In this episode we discuss how semaglutide performs as an antihyperglycaemic agent compared to previous GLP-1 analogues and the soon-to-be launched tirzepatide. This dual agonist also binds receptors to glucose-dependent insulinotropic polypeptide, GIP.GLP-1 and GIP are incretin hormones, secreted after food intake and involved in regulating gastric motility and appetite. The analogue therapies have resulted in weight loss of 10 to 20 percent in trials on patients with obesity or other weight-related comorbidities. For various reasons, however, they remain...2023-11-1354 min
Pomegranate HealthEp101: Setting the standard for workforce wellbeingWe’ve known for a decade that about 50 percent of doctors meet the criteria for burnout, and the figure is up to 70 percent among trainees. But organisations have been left to come up with their own solutions to this, the result being that many simply offer band aid solutions rather than systemic ones. Unforgiving work conditions pose a problem for both recruitment and retention of staff to the health workforce. The New Zealand Health Department, Te Whatu Ora, forecasts that within ten years supply of doctors, pharmacists and nurses will fall short of demand by 14 to 18 percent. In response th...2023-09-2656 min
MedAxiom HeartTalkTreating Patients Before It's Too LateFour out of five people don't know that they have cardiovascular disease until they end up in the emergency room. MedAxiom HeartTalk host Melanie Lawson speaks with Rahul Sharma, MBBS, FRACP, the director of structural interventions at Stanford Healthcare and the senior scientific advisor for egnite, about why structural heart patients experience an unreasonable wait time before treatment and how technology can be used to identify and treat patients before it's too late.Guest Bio:Rahul P. Sharma, MBBS, FRACP is the director of Structural Interventions at Stanford Healthcare, associate director of the Cardiac Catheterization Laboratory...2023-09-1325 min
Pomegranate Health[IMJ On-Air] A tiger in the mallee: Victoria’s JEV clusterOn the 28th of January 2022 a 75-year-old man was admitted to the regional Albury Wodonga Health Service with a high fever and Parkinsonian symptoms. The patient spent over a week in intensive care, but brain scans did not reveal an obvious aetiology and assays for a range of pathogens came up negative.When serology eventually revealed the presence of antibodies against Japanese encephalitis virus this became only the second ever locally-acquired case on Australia’s mainland. Even more startling was the fact that the previous one had been way back in 1998 in Cape York, far north Queensland. 2023-07-1743 min
CCO Infectious Disease PodcastCOVID-19 Update: Independent Conference Coverage of ECCMID 2023In this episode, Patrick W. G. Mallon, MB, BCh, PhD, FRACP, FRCPI, discusses new data on COVID-19 presented at ECCMID 2023, including:Treatment in special populationsREDPINE: remdesivir in people with renal impairment hospitalized for COVID-19 pneumoniaRemdesivir and readmission for COVID-19 in immunocompromised patientsMolnupiravir vs nirmatrelvir plus ritonavir for COVID-19 with hematologic malignancyManagement of patients with severe diseaseRECOVERY: higher-dose vs standard-dose corticosteroids for hospitalized patients with COVID-19Real-world study of tocilizumab vs baricitinib for severe COVID-19Novel antiviralsEnsitrelvirBemnifosbuvir Novel vaccinesNB2155AZD2816/AZD1222qNIV/CoV2373GRT-R910NVX-CoV2373 in people with HIVFaculty: Patrick W. G. Mallon, MB, BCh, PhD, FR...2023-05-0536 minPeerVoice Oncology & Haematology VideoJun-ichi Nishimura, MD, PhD / Austin Kulasekararaj, MD, FRCPath / Jeffrey Szer, MBBS, FRACP - Haemolysis in Paroxysmal Nocturnal Haemoglobinuria: Applying Assessment and Mitigation Strategies for Patients Receiving Complement InhibitorsJun-ichi Nishimura, MD, PhD / Austin Kulasekararaj, MD, FRCPath / Jeffrey Szer, MBBS, FRACP - Haemolysis in Paroxysmal Nocturnal Haemoglobinuria: Applying Assessment and Mitigation Strategies for Patients Receiving Complement Inhibitors2023-04-1429 minPeerVoice Oncology & Haematology AudioJun-ichi Nishimura, MD, PhD / Austin Kulasekararaj, MD, FRCPath / Jeffrey Szer, MBBS, FRACP - Haemolysis in Paroxysmal Nocturnal Haemoglobinuria: Applying Assessment and Mitigation Strategies for Patients Receiving Complement InhibitorsJun-ichi Nishimura, MD, PhD / Austin Kulasekararaj, MD, FRCPath / Jeffrey Szer, MBBS, FRACP - Haemolysis in Paroxysmal Nocturnal Haemoglobinuria: Applying Assessment and Mitigation Strategies for Patients Receiving Complement Inhibitors2023-04-1429 min
Pomegranate Health[IMJ On-Air] Hyperglycaemia and COVID-19In the first year of the COVID-19 pandemic, a handful of international studies showed that there was increased risk of adverse outcomes in hospitalised patients comorbid for diabetes. Odds ratios for mortality conferred by pre-existing diabetes ranged from 1.5 to 3.6. What this relationship might be in Australia was not known until researchers in Melbourne retrospectively examined electronic medical records from the two waves of COVID-19 in that city. The prevalence of diabetes among Melbourne inpatients is around 35% and in 2020 over 70% of all Australia’s case load was in Victoria. This presented an opportunity to observe the relationship between the...2023-01-1635 min
Pomegranate Health[IMJ On-Air] High readmission rates in cirrhotic patientsHospitalisation rates for cirrhosis are increasing in Australia in part associated with the high prevalence of obesity and subsequent non-alcoholic fatty liver disease. More concerning still is the frequency with which discharged patients are readmitted within 30 days. One systematic review put the average readmission rate at 26%, but the studies cited varied greatly in their inclusion and exclusion criteria and not much is known from Australia and Aotearoa-New Zealand. In the December edition of the Internal Medicine Journal researchers at the Austin Hospital Liver Transplant Unit in Melbourne reported a 46% readmission rate among their patients. This was based on a...2022-12-2139 min
Pomegranate Health[Guest Lecture] What we know about long COVIDADAPT is a prospective cohort study that has been following up COVID-19 patients since the earliest days of the pandemic. It has allowed researchers to track the emergence of long COVID, a syndrome that includes symptoms such as ongoing breathlessness, fatigue, chest tightness and "brain fog". Over the course of the study, participants have contributed blood cells, cardiac and brain MRIs, tests of respiratory function and more. The research has uncovered molecular and functional correlates that are helping to explain long COVID. Meanwhile, clinicians at the St Vincents’ Hospital, Sydney long COVID clinic are successfully applying rehabilitation str...2022-12-1441 min
Pomegranate Health[IMJ On-Air] Managing cannabinoid use in palliative careAbout two thirds of Australians use complementary and alternative medicines but only around half of these people will mention it to their doctor. Patients in palliative care settings may be more inclined than most to try therapies from outside the box. But they are also more vulnerable to side effects and interactions given that their drug metabolism and clearance mechanisms are often impaired. In this podcast you’ll hear the authors of a Clinical Perspectives article titled "Complementary and alternative therapies in the palliative setting." It’s published in the in the October issue of the Internal Medic...2022-10-2544 min
Pomegranate Health[IMJ On-Air] Recent advances in asthma managementThis is the first episode of a new format called “IMJ On-Air” inspired by the RACP’s Internal Medicine Journal. Each episode will be have as guest-host a section editor or reviewer of the IMJ interviewing authors of a recent article. Often these will be Clinical Perspectives reviews which summarise the latest in management of major medical disorders. In this episode we have leading respiratory physicians from the Royal Melbourne Hospital presenting current best practice in the diagnosis and treatment of severe asthma. They explain why inhaled corticosteroids have become so ubiquitous and also the remarkable impact that mo...2022-09-1446 min
Pomegranate HealthEp81: Advocacy from the TopIn episode 78 we heard from some physicians who found themselves taking up the role of advocate, not just for their own patients but for broader system change. And health policy lobbyist Patrick Tobin explained how physicians and the College as whole can best get the attention of parliamentarians. For example, the RACP’s Healthy Climate Futures campaign calls on Government to make the healthcare system more resilient against the shocks of climate heating and extreme weather events.To complete this series, this episode focuses on what happens to advocacy issues after they land on an MP’s desk...2022-06-0319 min
CCO Infectious Disease PodcastCOVID-19: Outpatient Therapeutic UpdatesIn this episode, Sharon R. Lewin, AO, FRACP, PhD, FAHMS, discusses: Principles for antiviral agent use in nonhospitalized patientsPreferred and alternative treatment optionsTreatment prioritization when there are logistical or supply constraintsOutpatient remdesivir usePINETREE data (adult patients)CARAVAN data (pediatric patients)FDA approval and treatment candidacyTherapeutic updatesIvermectin and the TOGETHER studyMonoclonal antibody use during current omicron eraPresenter: Sharon R. Lewin, AO, FRACP, PhD, FAHMSZDirector, The Peter Doherty Institute for Infection and ImmunityProfessor of Infectious DiseasesUniversity of MelbourneCo...2022-05-2435 min
Pomegranate HealthEp78: The Advocate’s JourneyThe core work of being a physician is demanding enough. But if you’re seeing patients come in day after day with ailments that have social determinants behind them, you may start to feel like Sisyphus; heaving that boulder up the hill only to have to start from the bottom every time it slips your grasp. Surely it would be better to change those socioeconomic drivers but where do you even begin? In fact, the three word mission statement of the RACP is Educate - Advocate – Innovate. In this podcast, former General Manager of Policy and Advocacy, Patri...2022-03-0238 min
CCO Infectious Disease PodcastCOVID-19: Omicron Transmissibility, Severity, and Vaccine EffectivenessIn this episode, Sharon R. Lewin, AO, FRACP, PhD, FAHMS, discusses what is known about the SARS-CoV-2 omicron variant, including:Transmissibility and infectiousness Immune evasionDisease severity Risks of hospitalization and death Vaccine effectiveness 2- vs 3-dose vaccine effectivenessT-cell responsePresenter: Sharon R. Lewin, AO, FRACP, PhD, FAHMSDirector, The Peter Doherty Institute for Infection and ImmunityProfessor of Infectious DiseasesUniversity of MelbourneConsultant Infectious Diseases PhysicianAlfred Hospital and Royal Melbourne HospitalMelbourne, AustraliaReview the downloadable slidesets at:...2022-02-2236 min
Pedia Pain FocusPharmacovigilance to Evaluate Efficacy and Net Clinical Benefit in Pediatric Pain MedicinePediatric pain management is fraught with reasons that make it feel like we are operating blindfolded. Many treatments are used without clear indications or evidence specifically in this population. What if you had a way to study what you do in pediatric pain management, while you do it, would you embrace it? In this episode, Dr. Drake Ross, a specialty pediatrician at Starship Children’s Health in Auckland, New Zealand with training in pediatric pain and palliative care, shares with us the features, goals and outcomes of their Rapid pharmacovigilance program, a multi institutional collaborative clin...2021-11-1651 min
CCO Infectious Disease PodcastLessons From Lockdown: Perspectives on Hepatitis C Care in the US and Australia—Audio RecapIn this episode, Gregory Dore, MBBS, PhD, FRACP, MPH, and Stacey Trooskin, MD, PhD, MPH, share lessons learned in the care of patients with HCV infection during the COVID-19 pandemic, including:TelehealthTreatment of PWIDTEMPO pilot studyMINMON studyPresenters:Gregory Dore, MBBS, PhD, FRACP, MPHProfessor, HeadViral Hepatitis Clinical Research ProgramKirby InstituteUniversity of New South WalesInfectious Diseases PhysicianSt. Vincent's HospitalSydney, AustraliaStacey Trooskin, MD, PhD, MPHChief Medical OfficerPhiladelphia FIGHT Community Health CentersFacultyDivision of...2021-11-1024 min
Pomegranate HealthEp73: Communicating a PandemicThere are many layers of public health interventions that can reduce the rate of transmission of the novel coronavirus. Social distancing, mask wearing, lockdowns and vaccines each nudge the reproduction number down. But you need all of them working together to make a significant impact, and that means you need the community on board. In this podcast we discuss the challenges and strategies around communicating public health messages to the public during a time of such high anxiety. Jessica Kaufman is a research fellow in the Vaccine Acceptance, Uptake and Policy Research Team at the Murdoch Children's R...2021-09-2349 min
CCO Infectious Disease PodcastThe Monoclonal Antibodies Strike Back: New Data on Their Use in COVID-19In this podcast episode, Sharon R. Lewin, AO, FRACP, PhD, FAHMS, and Arthur Kim, MD, discuss data on the potential use of monoclonal antibodies (mAb) for the prevention and treatment of COVID-19, including:Rationale for use of mAbPotential for resistance to mAbSingle vs combination therapy with mAbChallenges in implementation of mAb as treatment or preventionBamlanivimabSotrovimabCasirivimab plus imdevimabLink to full program, including downloadable slidesets: https://bit.ly/3zVTwYWPresenters: Sharon R. Lewin, AO, FRACP, PhD, FAHMSDirector, The Peter Doherty Institute for Infection and ImmunityProfessor of Infectious DiseasesFaculty Med...2021-09-1443 min
Pomegranate HealthEp71: Voluntary Assisted Dying—what have we learned?In 2017, Victoria was the first state in Australia to pass voluntary assisted legislation and has been followed by Western Australia, Tasmania and now South Australia. Aotearoa-New Zealand passed its End-of-life Choice Bill two years ago and that will go live in November. This podcast draws on the experience of some very committed Victorian clinicians who share the lessons they've learned over the last two years about practical implementation of VAD.The presenters were recorded at this year’s RACP Congress held in May. Palliative care physician Danielle Ko explained how Austin Health has prepared and supported its hea...2021-07-2046 min
Become your own Superhero podcastDr Pran Yoganathan - Gastroenterologist and Gastrointestinal endoscopist/Let food by thy medicine/🥩Dr Yoganathan graduated in medicine from the University of Otago in New Zealand. His training in internal medicine was undertaken in the Westmead Public Hospital. His Advanced training in Gastroenterology was completed in major teaching hospitals in Sydney. He is a Fellow of the Royal Australian College of Physician (FRACP) and a member of Gastroenterological Society of Australia (GESA). He has accredited expertise in Upper Gastrointestinal Endoscopy and Colonoscopy as certified by the Conjoint Committee for the recognition of training in Gastrointestinal Endoscopy.Dr Yoganathan has a strong interest in the field of human nutrition. He practices an...2021-04-2648 min
CCO Infectious Disease PodcastCOVID-19: Answering the Questions, Part 16In this episode, Part 16 of an ongoing series, Sharon R. Lewin, AO, FRACP, PhD, FAHMS, provides a brief update on emerging COVID-19 variants and their potential impacts on vaccine efficacy. After the update, Professor Lewin answers questions submitted by healthcare professionals on various aspects of COVID-19. Presenter:Sharon R. Lewin, AO, FRACP, PhD, FAHMSDirector, The Peter Doherty Institute for Infection and ImmunityMelbourne Laureate Professor of Infectious Diseases University of MelbourneConsultant Infectious Diseases PhysicianAlfred Hospital and Royal Melbourne HospitalMelbourne, AustraliaContent based on an...2021-02-1237 min
Psych Matters: History of Old Age Mental HealthProfessor Brian Draper: Interview with Professor Tony BroeIn this interview Brian Draper speaks with Professor Tony Broe.Professor Tony Broe AM, BA, MB BS, FRACP, FACRMSenior Principal Research Scientist, Neuroscience Research AustraliaProfessor of Geriatric Medicine, University of NSWNeurologist and GeriatricianProfessor Tony Broe AM graduated in social sciences (Anthropology, Geography, History) and Medicine from the University of Sydney. He trained in General Medicine (MRACP 1966), Geriatric Medicine and Neurology (FRACP 1973) in Sydney, University of Glasgow and the Mayo Clinic (1966 to 1973). He was head of the University Clinical School and Neuroscience at Lidcombe Hospital (1975 to 1985...2020-12-201h 07
Joint ActionWhat anti-inflammatory should I take for my osteoarthritis? with Ric DayThe first line pain relieving medication recommended in most therapeutic guidelines for osteoarthritis is the anti-inflammatory group of medications. They consistently demonstrate modest effects for relieving pain and improving function, pretty much irrespective of the site of osteoarthritis whether that be the hand, knee or hip. There is a huge variety of anti-inflammatories available, different routes of administration including oral and topical, different dosage strengths along with other elements that influence patient preference. On this episode we discuss: what are non-steroidal anti-inflammatory drugs (NSAIDs) and how do they work, what are the side effects of taking...2020-11-1542 min
CCO Infectious Disease PodcastCOVID-19: Answering the Questions, Part 11In this episode, Part 11 of an ongoing series, Sharon R. Lewin AO, FRACP, PhD, FAHMS, provides a brief update on the role of interferons in COVID-19. After the update, Dr. Lewin answers clinician questions on various aspects of COVID-19. Presenter:Sharon R. Lewin AO, FRACP, PhD, FAHMSDirector, The Peter Doherty Institute for Infection and ImmunityMelbourne Laureate Professor of Infectious Diseases University of MelbourneConsultant Infectious Diseases PhysicianAlfred Hospital and Royal Melbourne HospitalContent based on an online CME program supported by an independent educational gra...2020-10-2931 min
Gut TalkDr. Barry Marshall: Curiosity and Persistence in the Discovery of H. pyloriIn this podcast episode, we interview Barry Marshall, AC, FRACP, FRS, FAA, the legendary Nobel Laureate who discovered that peptic ulcer disease was caused by the bacteria Helicobacter pylori, not excess acid. Marshall fought for years against the notion that ulcers were caused by acid and finally infected himself with the bacteria and underwent endoscopy to prove his point. His research has saved countless lives, as untreated ulcer disease can lead to gastric cancer. We discuss numerous facets of his life and his pioneering work. Before antimicrobial therapy against Helicobacter, patients suffered for years without the right therapy. I...2020-10-191h 22
Pomegranate HealthEp62: Essential Ethics in Adolescent HealthIn episode 59 we shared a sampler of the Essential Ethics podcast from the Children's Bioethics Centre, at the Royal Children’s Hospital, Melbourne. A couple of cases studies were presented to help us define “the Zone of Parental Discretion” – a space in which decision-making about a child’s medical care is conceded to parents even if it’s not optimal clinical management.Today’s thought experiments come from the oncology department. First, we’re asked to consider when an adolescent should be permitted to make autonomous decisions about their health, even if these would lead to worse clinical outcome...2020-08-1142 min
Pomegranate HealthEp61: Delirium Part 2- Prevention and ManagementIn the previous episode we discussed the presentations and screening of delirium, as well as the risk factors. Just as important as these medical and iatrogenic precipitants are a host of environmental triggers that are highly modifiable. Anything that contributes to a person’s disorientation and discomfort can increase the likelihood of a delirium episode. While a lot of these factors are compounded in elderly and frail patients, it’s important not to be fatalistic. Delirium can be reversed in a majority of patients by non-pharmacological means. There are no medications indicated for treatment anywhere in the world. Psychtropic drug...2020-07-0934 min
Pomegranate HealthEp60: Delirium Part 1- Detection and CausesDelirium is associated with an increased risk of falls, dementia and high dependency care, and all of this adds up to higher mortality. About a third of patients admitted to ICU or approaching the end of life experience delirium. But it’s notoriously underdiagnosed, so in this episode we talk about the presentations and detection of delirium. We also go through some of the medical risk factors, including dementia, infection and metabolic disorders like hypercalcaemia. But even more common than these precipitants, are a host of drugs that can alter cognition or increase agitation by their anti-cholinergic properties. Importantly, we...2020-07-0831 min
CCO Infectious Disease PodcastCOVID-19: Answering the Questions, Part 3In this episode, Part 3 of an ongoing 12-part COVID-19 series, Sharon Lewin, AO, FRACP, PhD, FAAHMS, provides a brief update on the latest incidence trends and a concise guide to the management of mild and moderate disease. After the update, Dr. Lewin answers critical clinician questions on COVID-19 transmission, diagnosis, and management.Presenter:Sharon Lewin, AO, FRACP, PhD, FAAHMSDirectorThe Peter Doherty Institute for Infection and ImmunityProfessor of Infectious DiseasesUniversity of MelbourneConsultant Infectious Disease PhysicianAlfred Hospital and Royal Melbourne HospitalMelbourne, Australia...2020-06-2947 min
Pomegranate HealthEp59: Essential Ethics in PaediatricsThe ethical questions that come up in paediatrics can appear overwhelming to begin with. When can a child be said to have cognitive capacity and bodily autonomy? For those who don’t, where does the guardianship of the parent to give way to that of the medical professionals? When might treating one child have implications for the resources available to others? And what about not treating or vaccinating a child, if that’s what the parents want?All of these issues are tackled in the Essential Ethics podcast, produced within the Children's Bioethics Centre at the Royal Chil...2020-06-1534 min
Pomegranate HealthEp57: The Art of TelehealthCOVID-19 has left few people around the world unaffected, and health practitioners are among those at the top of the list. Their daily and intimate service to public inevitably puts them at risk of catching the virus, while social distancing precautions can compromise the work that they do. Dreadful as the viral disease is, the bigger consequences of the pandemic may be on the disruption to routine healthcare.Consulting patients by video or phone can be a way to keep healthcare ticking over, but many doctors are nervous as they adopt it for the first time. In...2020-04-2335 min
Pomegranate HealthEp55: Starting out in Private PracticeThis podcast is about one of many pathways in medicine; private practice. It’s a pathway that presents many opportunities, but also personal and financial challenges. When doctors are starting out in private practice, they typically do so within the safety net of an established practice, and perhaps only for part of the working week. In a simple model, they would be renting a room in exchange for an agreed portion of the consultation fees, to cover administration costs. The next level of complexity is setting up shop for oneself, and this requires registering a company in order...2020-02-0540 min
Pomegranate HealthEp54: My Health Record in PracticeHow many times have you thought “things would be so much more efficient if we had shared electronic health records?” Australia, now has the My Health Record covering 90% of the population with individual profiles. It is proposed that this will improve safety especially for people with chronic and complex health care needs. It could reduce medication mismanagement and duplication of pathology and diagnostic imaging tests and help improve health literacy among the public. And at the point of care it might prove safer for the previously unseen patient who arrives at emergency unable to say anything about what al...2019-12-0941 min
TopMedTalkPeriop SIG18 | Perioperative AnticoagulationThrombosis is the commonest cause of death and disability worldwide, antithrombotic therapy is incredibly beneficial but it promotes bleeding; how then do we manage anticoagulation in the peri-operative period? How do you assess a patient's risk of bleeding? When should you consider bridging? What are we to think as regards the current status of asprin? How do we approach dual anti platelet therapy (DAPT) and does it promote more bleeding? Lecture slides: http://www.anzca.edu.au/documents/03-harry-gibbs_periop-management-of-antiplatelet.pdf Presented by Harry Gibbs, FRACP, FCSANZ, The Alfred, Melbourne. -- 2019-10-0300 minTopMedTalkPeriop SIG 18 | Perioperative management in specific patient populations, panel discussionWhat do we now know about perioperative asprin? More specifically, what is the latest thinking on the results of the PeriOperative ISchemic Evaluation-2 Trial (POISE-2)? How do we educate patients about exercise? How do we support and help patients who have adverse outcomes to surgery? What's the best screening tool for malnutrition? Moderated by Dr Catherine Gibb, Consultant physician in perioperative care, Monash University and featuring Harry Gibbs, FRACP, FCSANZ, The Alfred, Melbourne, Stephan A Schug, Anaesthesiology and Pain Medicine, University of Western Australia and Royal Perth Hospital, Sunil K. Sahai, MD, FAAP, FACP, Co-Director, The PeriOperative...2019-08-1100 min
Pomegranate HealthEp49: Training in the Bush Part 2—Remote WAA third of Australia's population is classified as regional or remote, but as it's such a big place it's hard to provide comprehensive heath care all over. In the previous episode, we heard about an important referral centre in country NSW, but this episode takes us to Broome, a small town that's two and a half thousand kilometres from tertiary facilities in Perth.On average, remote settings like this only have 11 percent as many specialists per capita as major cities and this means that pathology is often more advanced by the time it's diagnosed. The medicine can...2019-07-1132 min
Pomegranate HealthEp48: Training in the Bush Part 1—Country NSWA third of Australia's population is classified as regional or remote, but since it's such a big place it's hard to provide comprehensive heath care all over. As a result, chronic disease gets treated later and mortality is 1.3 time higher than it is in major cities, according to the Australian Institute of Health and Welfare.There are only 42 percent as many specialists per 100,000 population in regional areas as there are in major cities, but research shows that these experiences are more likely to lead to permanent careers in the country.In this episode we visit...2019-07-0335 min
Pomegranate HealthEp47: Complex Adolescent Transitions—Congress 2019Everyone knows that adolescence is a turbulent time. Teens are faced not just with changes to their bodies, but to their moods and thought patterns as well. They might also be saying goodbye to familiar carers in the paediatric department, and in Episode 11 we heard how important it is to ensure a smooth transition to adult services, which tend to be more anonymous.This is especially true for young people with special needs such as diabetes, transplant management or intellectual disability, though they are the least likely to received dedicated transition support. The three speakers in this...2019-06-0529 min
Pomegranate HealthEp46: The First 1000 Days—Congress 2019This episode was recorded at the 2019 RACP Congress in Auckland and deals with the profound influence that the first 1000 days of life have on lifelong health, wellbeing, behaviour and socioeconomic outcomes.Professor Richie Poulton outlined the influential Dunedin Multidisciplinary Health and Development Study, which has followed over 1037 participants since 1972. All sorts of measures have been taken throughout the participants' lives, but Dr Poulton showed the incredible predictive power of one behavioural trait in particular: self-control.Paediatrician Dr Johan Morreau revealed how such associations between childhood deprivation and behavioural outcomes might be explained by developmental neuroscience. And...2019-06-0437 min
Pomegranate HealthEp45: Medical Fitness to DriveAustralia and NZ are made up of sprawling cities and far-flung towns, and driving is often viewed as a fundamental freedom. It can be hard for clinicians to challenge that freedom with patients who they consider unfit to drive safely. And harder still to deal with the consequences if a patient does have a crash.Clinicians are drawn into the question of driving fitness in two main ways. The more clearcut is when a patient presents with a medical assessment form. It's the Driver Licencing Authority in each state which ultimately issues the driving permits and may...2019-04-1742 min
Sigma Nutrition Radio#272: Barbora de Courten, PhD – Effect of Carnosine on Glucose Metabolism and Chronic Disease RiskLinks: Go to episode page Receive Danny's free emails Subscribe to Sigma Nutrition Premium About This Episode: Professor Barbora de Courten, MD PhD FRACP MPH is a Professor at Monash University, Australia. She is a National Heart Foundation Future Leader Fellow and a specialist physician with a PhD in epidemiology, extensive training in clinical trials (NIH) and a Master of Public Health (Monash University). She has expertise across the translational research continuum from epidemiology, human mechanistic studies to clinical trials and public health interventions through to practice. She is passionate about research into h...2019-03-0929 min
Rotary Melbourne PodcastProf Susan Davis, Monash UniversityProfessor Susan Davis MBBS FRACP PhD FAHMS
Speaking on “Inequitable Equity”
Professor Susan Davis MBBS FRACP PhD FAHMS is an Australian National Health and Medical Research Council Senior Principal Research Fellow and Director of the Women’s Health Research Program in the School of Public Health and Preventive Medicine, Monash University Melbourne.
She is a consultant Endocrinologist at Cabrini Medical Centre and Head of the Women’s Specialist Clinic, the Alfred Hospital Melbourne. She is a Fellow of the Australian Academy of Health and Medical Sciences and presently President of the International Menopause Society.
Prof Davis graduated in medicine from Monash U...2019-03-0622 min
Pomegranate HealthEp41: Targeting DiabetesGlucose-lowering medications have been the mainstay of managing type 2 diabetes for 20 years, but in April this year a polemic erupted around specific targets for blood sugar. The American College of Physicians recommended less stringent control than had been previously accepted, and invoked fierce criticism from other diabetes organisations around the world.It all comes down to the interpretation of four key trials between designed to show a link between intensive glycemic control and improvement in cardiovascular symptoms. On this episode, Dr Paul Drury and Professor Sophia Zoungas help make sense of the inconsistencies between the findings and...2018-11-2036 min
Pomegranate HealthEp40: Rebooting CPD Part 2—Feedback and AuditFrom 2019, there will be only three categories of activities in the RACP's CPD framework, encouraging Fellows to participate in performance review and outcome measurement alongside more traditional educational activities. Performance review can include collegiate exercises like peer review of case outcomes, or surveys of patient experiences. Multi-source feedback is one sophisticated example that has been trialled by the RACP. Outcome measurement typically refers to clinical audits of case notes and there are many forms that can easily be implemented by Fellows. In this episode, two New Zealand Fellows discuss what they've learned about this 'strengthened CPD' approach since it...2018-09-2630 min
Pomegranate HealthEp39: Rebooting CPD Part 1—OriginsIn this episode we put continuing professional development (CPD) under the microscope, particularly the regulatory changes on the horizon. The Medical Board of Australia is emulating shifts already made by the Medical Council of New Zealand and regulators in Canada, the U.S. and the U.K. In some cases, this 'revalidation' movement has been fiercely opposed by doctors. But where did it come from, and why is CPD even necessary after you've already done 10 to 15 years of medical training.Guests Professor Richard Doherty FRACP (Dean, RACP; Monash Childrens Hospital and University) Dr C...2018-09-2531 min
Pomegranate HealthEp38: Making a ConnectionAn empathic connection and good communication between physician and patient can promote better outcomes. In this episode of Pomegranate Health, U.S. physician A/Prof Danielle Ofri discusses where breakdowns in doctor-patient communication occur—often in the first 10 or 20 seconds of a consultation. Dr Ofri, author of What Patients Say, What Doctors Hear, suggests ways for physicians to listen better, to be understood and promote adherence.Some media also report a 'crisis of compassion' in healthcare. Burnout of staff is a major contributor, and palliative care physician Dr Shamsul Shah describes how to mitigate it by convening gr...2018-07-1532 min
Pomegranate HealthEp37: Ethical Dilemmas—Congress 2018As medicine becomes more sophisticated, discussions about clinical ethics become more common. It is now possible to support life in dire clinical circumstances, but physicians are not always sure if this is the right thing to do. There are questions about quality of life and best interests of the patient, questions about cognitive competence to make such decisions for oneself or questions about equitable distribution of limited resources.This episode was recorded at the RACP Congress in May and centres around two case studies. The first describes a three-year-old boy with a severe neurodegenerative disorder whose parents...2018-06-1341 min
Pomegranate HealthEp36: Acute Coronary Syndrome Part 2—Secondary PreventionThis is the second of two episodes about acute coronary syndrome (ACS). In part one, the discussion focused on diagnostic workup of acute coronary events. This episode deals with secondary prevention and adherence to therapy. One-fifth of people discharged with a diagnosis of ACS have another ischaemic event within six months, and the risk of dying increases the second time round.There is an established strategy for secondary prevention of ACS that includes pharmacotherapy, cardiac rehabilitation and lifestyle management. However, 75 per cent of patients are discharged from hospital without one or more of these tools. A recently...2018-05-2332 min
Pomegranate HealthEp33: Early Days for Cannabis TherapyCannabis is a plant rich with potential therapeutic compounds and centuries of cultural resonance. At this moment in Australia, media accounts are full of patient stories and lab data suggesting benefit from cannabis for scores of different conditions, while politicians discuss laxer regulation of the drug and a new lucrative industrHowever, only a few of the claimed medical effects of the plant have been proven by rigorous clinical trials in people. Nabiximols is the only medicinal cannabis product currently registered in New Zealand and Australia, and it's indicated only for the treatment of spasticity in patients wi...2018-01-3036 min
Pomegranate HealthEp32: Diagnostic Error Part 1—Cognitive BiasMisdiagnosis or delayed diagnosis occurs in 10-15 per cent of acute presentations, although fortunately only a tenth of these lead to serious consequences. But of concern is the fact that this figure hasn't changed in three decades, despite progress in clinical knowledge. Errors in diagnostic reasoning occur at the same rate in senior clinicians as they do in juniors, even though mistakes from poor examination or knowledge become less frequent as one gains experience. Compared to problems in maths or physics, diagnostic problems are thought of as ill-structured: because information isn't readily available, the problem can keep c...2017-12-2034 min
Pomegranate HealthEp29: Drug Interactions and DeprescribingAdverse drug events cause about five per cent of admissions to a public hospital, although some studies suggest the figure could be as high as 15 per cent. That makes at least half a million patients in Australia and 55,000 in New Zealand every year. Drug-drug interactions make up about a fifth of these adverse events. They have become more frequent over the decades, as more medications reach the market. More than half of people over the age of 75 are on five or more prescriptions—a state referred to as polypharmacy. This episode examines some of the syst...2017-09-2628 min
Pomegranate HealthEp28: Transitions to FellowshipThe transition from trainee to consultant marks an exciting and daunting step in a clinician's career. Suddenly you take on responsibility for everyone on the ward—both patients and other staff. And while clinical skills have been hammered in over years of training, the 'hidden curriculum' can be harder to pick up. The College has recently published How to Thrive as a New Consultant, a handbook to help navigate this period with confidence.For today's show, guest producer Zacha Rosen spoke to four physicians who look back on their transitions, from six months on to nine years on...2017-08-2726 min
Pomegranate HealthEp23: Managing Autism in the EDPatients with autism spectrum disorder (ASD) can present unique challenges for the emergency physician. As these patients often have trouble making sense of their own emotional and physical states, they can become very distressed when experiencing pain. Many are also limited in their language abilities, and therefore can’t communicate verbally what is wrongIn this episode of Pomegranate, carer Annette talks about raising her teenage grandson Aaron, who needs continual care. Consultant paediatrician Meenakshi Rattan FRACP (Campbelltown Hospital, NSW), and psychiatrist Kenneth Nunn FRANZCP FRACP (Children’s Hospital Westmead, NSW) share the techniques they use to calm...2017-04-2627 min
Pomegranate HealthEp22: Transitions to RetirementThis episode looks at one of the biggest steps in a physician's career: retirement. It's common to avoid thinking about retirement, and the idea can sometimes come as a shock—professionally, personally, or financially. This month, we speak with physicians both in and out of retirement, as well as two psychiatrists whose research focuses on medical professionals' identity.Guests A/Prof Jill Sewell FRACP (Royal Children's Hospital, Melbourne) A/Prof Carmelle Peisah FRANZCP (Consultant Old Age Psychiatrist, Conjoint Professor UNSW, Clinical Associate Professor University of Sydney) Dr Chanaka Wijeratne FRANZCP (Prince of Wa...2017-03-3026 min
Pomegranate HealthEp21: Genomics for the Generalist – Part 2This is a two-part series looking at how modern genomics is changing clinical practice, and how a physician can hope to keep up with the pace of discovery and technological development. Some single gene tests and gene panels have been available off-the-shelf for years, but whole genome sequencing is becoming more accessible and affordable every day. In the first episode we discussed the differences between these technologies in terms of cost and practical utility, using diagnosis of Mendelian conditions and rare developmental conditions as examples.The second episode begins with the question of disease risk and how...2017-02-2727 min
Pomegranate HealthEp20: Genomics for the Generalist – Part 1This is a two-part series looking at how modern genomics is changing clinical practice, and how a physician can hope to keep up with the pace of discovery and technological development. Some single gene tests and gene panels have been available off-the-shelf for years, but whole genome sequencing is becoming more accessible and affordable every day.In the first episode we discuss the differences between these technologies in terms of cost and practical utility, using diagnosis of Mendelian conditions and rare developmental conditions as examples. We also talk about counselling parents through prenatal or preconception screening, and the...2017-02-2624 min
Pomegranate HealthEp17: Better Practice in PaedsAlmost three quarters of physicians surveyed in the U.S. admit to ordering at least one unnecessary test, procedure or treatment every week. In Australasia, EVOLVE is the RACP's initiative to minimise clinical practices that aren't supported by the current evidence base, and stems from the international healthcare campaign Choosing Wisely.EVOLVE has recently published a list of the top five practices in general paediatrics that need to be pulled back. Developed in consultation with Fellows from the RACP Paediatrics and Child Health Division, its recommendations are:Do not routinely prescribe oral antibiotics to children with...2016-11-2927 min
Pomegranate HealthEp16: Mind the (Gender) GapWhile more than half of all medical students and trainees are women, they make up only about 30 per cent of registered physicians. When it comes to clinical leadership positions it's down to single digits, and medicine's gender pay gap is worse than that of other industriesThe reasons for this loss of talent, and disparities in pay, are both cultural and logistical. One significant factor affecting career progression is time taken out for child-rearing; the penalties associated with such an interruption appear to compound more in medical training than they do in other professions. But medical culture...2016-10-3024 min
Pomegranate HealthEp14: Fever of Unknown OriginPyrexia, or fever of unknown origin (PUO) is a syndrome that challenges the diagnostic skills of every physician. It is defined by frequent fevers over 38.3 degrees Celsius, persisting for 3 weeks, which have eluded diagnosis by standard baseline tests.Dr Rohan Beresford, Advanced Trainee in infectious diseases and microbiology and Professor Iain Gosbell of the University of Western Sydney, review the condition in September's issue of the RACP's Internal Medicine Journal. In a recent case series, they write, 22% of PUO cases were auto-inflammatory, 16% were attributed to infection, 7% were neoplastic, and 4% were due to drugs or other miscellaneous causes...2016-08-2824 min
Pomegranate HealthEp13: A Fresh Start for Disability ServicesThe National Disability Insurance Scheme (NDIS) is designed to provide better care for the 460,000 Australians who have significant and permanent disability. The NDIS supports individuals in making personalised therapy goals, accessing appropriate care, and participating in mainstream life. Since 2013 the scheme has had a staged launch across parts of Australia. This month, the NDIS will start rolling out across New South Wales and Victoria and will have complete coverage by 2019.On this episode internal medicine physician Dr Robyn Wallace FRACP, of Calvary Hospital in Hobart, explains how the NDIS differs from past disability services, and rehabilitation specialist...2016-07-2522 min
Pomegranate HealthEp11: Adolescent Health Adds UpThe World Health Organization defines 'adolescents' as anyone between the ages of 10 and 19, and 'youth' as those between 15 and 24. The RACP uses the terms 'young people' and 'adolescent and young adult' to cover the whole range of 10 to 24 years. Regardless of how it's defined, the transition from childhood to adulthood involves a range of physical, mental, and psychosocial issues. If you're a teenager with a chronic health condition, the situation can be even harder.For physicians in Australia and New Zealand, there has been no specific training to meet the needs of adolescents—until now. Over the pa...2016-05-3021 min
Pomegranate HealthEp10: Evolving Your PracticeMedical practice is dynamic, and continually changes with evidence and experience. But costly or prolonged treatment doesn 't always translate into better outcomes for patients. In response, the College has launched EVOLVE—a partnership with specialty societies to identify and reduce low-value care.EVOLVE is part of a growing international movement to examine clinical and consumer decision-making about overused, inappropriate, or potentially harmful medical treatments. As a founding partner of Choosing Wisely Australia, EVOLVE represents the College 's major contribution to the campaign: helping Fellows develop and promote lists of low-value care items for their specialty. On th...2016-04-2623 min
Pomegranate HealthEp9: The Gut Microbiome and IBDThe gut microbiome is the subject of increasing research in medicine. Understanding this complex community offers potential new insight for treating a number of diseases—gastrointestinal and otherwise. But what's the evidence base?In this episode Dr Peter De Cruz FRACP, Head of the Inflammatory Bowel Disease Service at the Austin Hospital, discusses his recent IMJ article 'Characterisation and Therapeutic Manipulation of the Gut Microbiome in Inflammatory Bowel Disease'. To provide further review, the episode also features an interview with Professor Finlay Macrae FRACP, Head of Colorectal Medicine and Genetics at the Royal Melbourne Hospital.In...2016-03-2924 min
Pomegranate HealthEp8: Obesity Inside OutObesity can seem like what strategists call a 'wicked problem'—a problem with so many parts that it's impossible to solve. But some things are changing. While prevalence is still high in developed countries, childhood obesity appears to be plateauing. Social movements like 'Health at Any Size' promote body positive approaches. And at Dr Nic Kormas' clinics, obese patients on average are able to lose 10% of their weight.Dr Kormas FRACP is the senior endocrinologist behind the Metabolic Rehabilitation Programs at Concord, Camden and Campbelltown Hospitals. He's joined on the program by Dr Jacqui Curran FRACP, a pa...2016-02-2824 min