Study a worthwhile trial
Perth Children’s Hospital (PCH) has been chosen as the lead Australasian site for the international PROSpect study, the Prone and Oscillation Paediatric Clinical Trial.
PROSpect principal Investigator Professor Martha Curley from the renowned paediatric intensive care unit (PICU) of the University of Pennsylvania’s School of Nursing was in Perth to meet the study team.
The trial will benefit patients who require ventilation due to acute and severe respiratory failure and aims to identify which combination of ventilation (conventional or high frequency oscillation) and positioning (either supine or prone) is the most effective.
Head of Paediatric Critical Care at PCH Dr Simon Erickson said Professor Curley’s visit was a boost for the PCH PROSpect study.
“Professor Curley’s visit provided welcome recognition of our success with this trial and the fact we have become the lead Australasian site,” he said. “This achievement reflects our dedication to this project and our commitment to improving the outcomes of our patients, particularly given the challenges of recruiting participants to trials like this.”
Fifteen-year-old Annabelle Carr has spent a significant amount of time in the PICU having undergone more than 80 surgical procedures over her lifetime. The procedures relate to her oculodentodigital dysplasia, a rare genetic condition that affects many parts of the body particularly her eyes, teeth and fingers.
Last year Annabelle became acutely unwell with abdominal pain and underwent emergency surgery at PCH to remove part of her large intestine. She later developed sepsis. She then had to have emergency open heart surgery followed by four weeks in ICU. Her mother Marina consented to be part of the PROSpect study during this time despite her daughter being so unwell.
“It was hard to see Annabelle lying on her stomach once she was part of the trial, but we were pleased at how quickly she recovered, and the ventilator was removed. Despite the stress at the time we knew participating in this study would help other patients in the future,” Mrs Carr said.
Annabelle has now fully recovered from this experience and is pursuing her passion for writing with renewed vigour.
Voting with their feet
Changes to working conditions at North Metropolitan Health Service sites have been given the thumbs up by the junior doctors the service hopes to attract and retain.
The Junior Doctor Manifesto, devised by Dr George Eskander and his team, has seen 33 part-time positions created, which as has led to a drop in vacancy rates from 42 positions to nil in February 2023. It has been a remarkable turnaround from a previously stressed junior doctor cohort that saw increasing absenteeism, to a workforce that is enjoying part-time flexibility.
“These part-time opportunities – enshrining a culture of psychological safety, creating a streamlined overtime approval process, embedded leave-taking and implementing a medical workforce on-call, along with a below the line pathway for reporting – have really challenged previous behaviours and traditions within the group,” Dr Eskander said.
“Our doctors are [now] reporting much greater satisfaction. We increased our retention rate and approved 75% of requests for annual leave within five days and 94% of our interns have renewed their contracts to further their medical careers and, for us, that has had a profound impact on our overall workforce.”
Payroll relief
The Royal Australian College of GPs has had confirmation that the Western Australian Government does not intend to change the way its existing payroll tax provisions apply to general practice.
RACGP WA Chair Dr Ramya Raman received written confirmation from the government after raising member concerns that WA might follow other states in putting an additional payroll tax burden on GP practices.
Practice owners across Australia already pay payroll tax on their employees, including receptionists, registrars, and nurses, but it hasn’t previously applied to GPs. This is because most doctors are not employees – they lease rooms and facilities from a practice owner and operate under independent agreements.
However, recent court judgements in New South Wales have considered GPs at certain medical practices as employees for payroll tax purposes. The RACGP has been advocating strongly in all states since and has secured amnesty periods for GPs in South Australia and Queensland.
Deputy Premier and Treasurer Rita Saffioti said under WA’s existing payroll tax provisions, most GPs working in medical practices under independent agreements “are considered contractors running an independent business. The $1 million tax free threshold means the majority are not subject to payroll tax. The Western Australian Government does not intend to change these provisions.”
RACGP WA Chair Dr Ramya Raman welcomed the confirmation as a relief for WA’s GPs.
“Practices operate on thin margins, and if they are hit with an additional payroll tax bill, which can be hundreds-of-thousands of dollars, they will be forced to pass the costs on to patients. If patients can’t afford the gap fees, practices will close,” she said.
Be resolute
The Resolute team headed by psychiatrist Dr Richard Magtengaard is preparing for its first clinical masterclass – “Caring for those who Serve” at the UWA Club on Saturday, September 2.
Resolute has constructed and is executing a comprehensive approach toward integrating high-quality, trauma-informed clinical services for ADF personnel, veterans, first responder communities, and their families. This year it is partnering with Soldiers & Sirens for the masterclass.
Dr Magtengaard said clinicians were welcome to attend alongside those who have served (and their supporters) to learn from experts across respective specialties, and gain meaningful insights
from those with a lived experience.
The program includes presentations from James Hepworth, principal of the Veteran Employment Program at Roy Hill, Dr Michael Winlow on medicinal cannabinoids and therapeutic application, exercise as medicine by Katie Stewart and Alex Lim on ketamine, neuroplasticity, treatment-resistant depression and PTSD among other topics.
For clinicians, eight hours of CPD points can by claimed.
All proceeds from the day will go to Soldiers & Sirens WA charity.
Tickets from https://www.trybooking.com/CJNDA and information from hello@resolute.support | www.resolute.support
A new-old tummy bug in town
A type of bacteria not routinely tested for has been discovered as the second most common cause of bacterial gastroenteritis, in a study of over 300,000 patient samples.
Researchers from UNSW Sydney have identified Aeromonas as the offending bacterial pathogen.
Until now, it has been believed that after Campylobacter, Salmonella was the next most suspected.
“Our results have found that Aeromonas are the second most prevalent enteric bacterial pathogens across all age groups and are, in fact, the most common enteric bacterial pathogens in children under 18 months,” said Assoc. Professor Li Zhang.
The latest findings, published in Microbiology Spectrum, could have an impact on the diagnostic process for gastroenteritis and ultimately lead to more targeted treatment.
“Historically, Aeromonas species have been largely overlooked and understudied, but they are increasingly recognised as emerging enteric pathogens globally,” A/Prof. Zhang said.
The team analysed quantitative real-time PCR data from 341,330 patients with gastroenteritis in Australia between 2015 and 2019 and results were grouped by patient age. Researchers identified a unique infection pattern, characterised by three distinct infection peaks associated with age.
“The occurrence of Aeromonas enteric infections was predominately observed in young children and individuals over 50 years old, suggesting a higher susceptibility to these infections during stages where the immune system tends to be weaker,” says A/Prof. Zhang.
“These findings suggest that both human host and microbial factors contribute to the development of Aeromonas enteric infections.”
“But the high rate of Aeromonas infection discovered in our study, and significantly, how they are impacting different patient age groups, suggest that Aeromonas species should be included on the common enteric bacterial pathogen examination list,” says A/Prof. Zhang.
Strong grant uptake
More than $8 million has now been paid to 340 Western Australian general practices following their applications for a Strengthening Medicare General Practice Grant.
With more than 600 applications lodged with WA Primary Health Alliance (WAPHA), the grants are set to support these WA practices to expand patient access.
Most practices have opted to invest their grant across three different (or combined) streams – enhancing digital capability, upgrading infection control, and maintaining or achieving practice accreditation.
A statement from WAPHA said that while the GP grant application process involved additional steps compared to other initiatives, “most WA general practices are now set up as a WAPHA supplier. The benefit of this to practices is that applications for future funding opportunities, such as those flagged in the May 2023 Federal Budget, will be streamlined.”
Get2it
Data from the Australian Institute of Health and Welfare released results of its cancer screening audit and in the March quarter this year, 846,000 invitations to participate in the bowel cancer screening program were sent to eligible people aged 50-74.
Of these invitations, 52% were sent to women (437,000) and 48% sent to men (409,000), with 363,000 kits returned for analysis. Of these, 54% were returned by women (197,000) and 46% returned by men (166,000).
The number of completed kits returned was higher than in the December quarter (296,000) and the March quarter a year prior (193,000).
The March quarter 2023 experienced a peak in the number of invitations sent and the number of completed kits returned (846,000 invitations and 363,000 kits respectively) compared to the March quarters of the three previous years (496,000 invitations and 193,000 kits in 2022, 693,000 invitations and 243,000 kits in 2021 and 752,000 invitations and 166,000 kits in 2020).
Observable drops in the number of invitations during summer months was potentially due to the NBCSP Hot-Zone policy, where less invitations were sent to locations where average monthly temperatures are greater than 30°C. Blood present in a collected sample may break down and be more difficult to detect when exposed to high temperatures.
HBF in the gym
Eighteen months after acquiring Life Ready physiotherapy clinics, HBF is preparing to rebrand five of the 19 West Australian outlets to HBF Physio. Baldivis, Busselton, Butler, Midland and Rockingham locations will get the name change, while a new clinic in Bull Creek will open alongside the existing local HBF Dental centre.
Physiotherapy is HBF’s third most-claimed ancillary benefit, accessed by 160,000 members who spend $75 million on physiotherapy services annually.
“Our expansion into the delivery of health services through not only the acquisition of Life Ready last year but also the establishment of HBF Dental enhances the value of private health insurance for our members,” said HBF’s Dr Daniel Heredia.
He said Life Ready and HBF Physio clinics were open to anyone, regardless of their health fund membership and clinical decisions would continue to be made independently by practitioners.
HBF Physio will provide exclusive offers, including a no-gap standard initial physiotherapy consultation for eligible HBF members. And the fund would also cover relevant members for the GLA:D osteoarthritis education and exercise program at Life Ready and HBF Physio clinics.
Smiles are getting wider
Growing knowledge of the importance of a healthy mouth for overall health and well-being makes access to dental services a priority for the charity Kimberley Dental Team, which was founded by Jan and John Owen in May 2009.
Then, Dr John Owen accompanied his wife Jan, a dental nurse and educator, to Halls Creek because Jan was singing with the Madjitil Moorna students choir comprising children of the Halls Creek District High School. The school welcomed their dental expertise as they had been without a dental therapy service for a considerable time.
It got them thinking about the inequality of dental health care in the remote north so they developed a volunteer team of dental health professionals and the Kimberley Dental Team (KDT) was born.
They have been busy during June and July with two incursions with teams visiting Fitzroy Crossing, having to negotiate the new temporary crossing across the Martuwarra (Fitzroy) river. They ran clinics in numerous communities then on to Halls Creek, Kununurra and back to Halls Creek with stops all along the way. Clinics were set up from district hospitals to front verandas and everything in between.
KDT has collegiate sponsorship from dental groups as well as the McCusker Foundation, Rotary and this year received a grant through the Office of the Chief Dental Officer.