more_vertIt is easy to use the word “unprecedented” when reviewing recent statistics about young people. We have the largest generation of adolescents in human history, their prospects for formal education are escalating, and previously tenacious disparities in school attendance between boys and girls are dwindling.1 From 1985 to 2016, the proportion of young people enrolled in secondary schools increased from an estimated 47% to 76%.2 Schools are consequently increasingly accessible for learning and socialisation.
Preference: Education
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#GoodDoctorsTeach Australian Medical Students’ National Teaching Awards
BY ALEX FARRELL, PRESIDENT, AUSTRALIAN MEDICAL STUDENTS’ ASSOCIATION
Every day, great doctors around Australia go above and beyond to teach students, and role model what medicine is all about. This year the Australian Medical Students’ Association (AMSA) celebrated those teachers in medical schools and hospitals with the National Awards for Teaching Excellence.
The AMSA National Awards are the highest honour bestowed on a teacher by medical students across the country. They are based on nominations from around the country, and represent students’ appreciation and recognition of teachers who have made an especially positive impact on their studies. There are a number of award categories including excellence in teaching, in rural education, teaching by a junior doctor, and as well as teaching by a member of an allied health profession.
Although it is such an important part of the doctor’s role, the teaching culture across different hospitals varies widely. Despite the recent focus and positive steps in the last few years, bullying, harassment, and teaching by humiliation are still too common an experience. These awards are part of AMSA’s #GoodDoctorsTeach campaign, acknowledging those who tackle this by actively creating a positive teaching culture within medicine.
AMSA received close to 100 nominations for the awards. Reading those nominations was heart-warming, as student after student shared stories of the teachers who have inspired, motivated and challenged them. It was a reminder of just how significant the impact of teaching is on the lives of students, and of how many exceptional teachers there are.
On behalf of Australian medical students, I’d like to thank all the doctors and allied health professionals who make it part of their daily work to make medicine a welcoming and exciting place for students and junior doctors, and nurturing their passion. Consultant or intern; metropolitan or remote; doctor, midwife or echocardiographer: the way you treat your students is making for better future doctors, and a better medical culture in Australia.
Excellence in Teaching winner: Dr Zafar Smith (James Cook University)
Quote from students: “Dr Smith has gone above and beyond teaching us Emergency Medicine in our 3rd year. He completely re-vamped the course making it much easier to learn and more enjoyable. Every single person I know has enjoyed his lectures, tutorial and approachability. He uses interactive methods of teaching which engage the class, such as gosoapbox and kahoot quizzes to test us, and has even created a deck of cards with Emergency medicine case studies that we were all able to get our hands on and use for our exams. As this is his first year of coordinating and lecturing this course, he has outdone himself and on behalf of Med 3 at James Cook University, we would like to recognise his efforts and generosity, and the fun spirit he has brought to sometimes difficult topics.”
Excellence in rural education winner: Dr Elizabeth Kennedy (University of Melbourne, Goulburn Valley Region)
Quote from student: “Dr Kennedy has provided me with outstanding mentorship over 2018, cementing my passion for rural medicine … She is consistently motivated to include students in the extracurriculars of the medical profession, including education events in the Goulburn Valley Region, attending Youth Forums regarding young women’s health, and promoting student engagement in the community. She constantly provides me with the mentorship and support to strive for more, and to be the kind of person and doctor that is needed in a rural area. She constantly gives her medical knowledge, emotional support and more to her patients and I learn from her each and every day.”
Excellence in teaching by a junior doctor winner: Dr Kenneth Cho (University of Sydney and University of Western Sydney, Nepean Hospital)
Quote from selection panel: “Kenneth’s work developing a JMO-led bedside tutorial program and a JMO-led Friday lecture series, run by Junior Medical Officers for medical students is an example of the way anyone, despite age or experience, can lead by example to create a culture of teaching where they work.”
Excellence in teaching by a member of an allied health profession winner: Mr David Law (Echocardiographer, University of New South Wales, Coffs Harbour Hospital)
Quote from student: “David- Coffs Harbour’s most prized sonographer- is probably the only teacher I’ve had who has been able to explain ECGs in a way that makes sense. But more important than that is how he has made the hospital such an inclusive place for medical students to be, welcoming us to catheterisation lab, and always taking the time to explain things to us.”
AMA supports asylum seeker medical treatment bill
The AMA supports the asylum seeker Urgent Medical Treatment Bill being promoted by Independent MP and former AMA President, Professor Kerryn Phelps.
The AMA has gained assurances on key amendments to the legislation in recent days.
The Phelps bill will allow the temporary removal of children from offshore detention, create a workable system providing proper health care for refugees and asylum seekers under the protection of the Australian Government, and keeps in place deterrents that prevent asylum seekers risking their lives at sea and endangering themselves and others.
AMA President Dr Tony Bartone said that it was vital that all asylum seekers and refugees in the care of the Australian Government have access to quality care.
“There is compelling evidence that the asylum seekers on Nauru, especially the children, are suffering from serious physical and mental health conditions, and they should be brought to Australia for appropriate quality care,” Dr Bartone said.
“This week’s alarming Médecins Sans Frontières report on the health of detainees on Nauru was another signal that urgent action is needed.
“This is a health and human rights issue of the highest order. We must do the right thing.
“The amended Phelps bill is an important measure that will allow the temporary transfer to Australia from Nauru and Manus sooner for those in need of urgent care.
“The AMA has been advocating strongly for better health care for asylum seekers for many years.
“Our 2015 Position Statement, Health Care of Asylum Seekers and Refugees, called for the removal of all children from offshore detention, among other measures.
“We want a new national statutory body of clinical experts, independent of government, with the power to investigate and advise on the health and welfare of asylum seekers and refugees.”
The AMA is pushing for further legislation that incorporates the following reforms:
- asylum seekers and refugees should have access to the same level of health care as all Australian citizens;
- asylum seekers and refugees living in the community should have continued access to culturally appropriate health care, including specialist care, to meet their ongoing physical and mental health needs, including rehabilitation;
- all asylum seekers and refugees, independent of their citizenship or visa status, should have universal access to basic health care, counselling, and educational and training opportunities; and
- asylum seekers and refugees living in the community should have access to Medicare and the Pharmaceutical Benefits Scheme (PBS), state welfare and employment support, and appropriate settlement services.
Dr Bartone wrote to Prime Minister Morrison in September calling for the children on Nauru to be brought to Australia for appropriate medical care, with similar letters going to all MPs and Senators.
“We have worked closely with the Chief Medical Officer of the Home Affairs Department, and we acknowledge that the Government has since removed some of the children from Nauru,” Dr Bartone said.
“But we need a compassionate and enduring long-term solution that ensures quality appropriate health care for all asylum seekers and refugees in the care of the Australian Government.”
Government expands football partnership aimed at young Indigenous health
The health, wellbeing and future prospects for children in remote communities will be winners, through a major extension of the successful John Moriarty Football program to 12 centres across New South Wales and Queensland.
The Federal Government is committing up to $4.5 million for the expansion, to be driven through a partnership between the Football Federation of Australia (FFA) and John Moriarty Football (JMF).
JMF and FFA will work together to provide senior coaching staff, mentoring, training and education for children involved in the program. FFA will also identify and support pathways to national football programs.
“This is a game-changing move for Aboriginal and Torres Strait Islander communities, designed to help children between two and 16 to reach their full potential in football, in education and in life,” Indigenous Health Minister Ken Wyatt said.
“We have seen the success in the remote Northern Territory centres of Borroloola and Robinson River, which have been involved in the program since it was established in 2012, with more than 90 per cent of children in Borroloola now participating.
“Two hundred children have enrolled each year, including Shay Evans who is now playing with the Westfield Young Matildas.
“I congratulate Shay and her fellow JMF scholarship winners, but scores of other participants are also continuing to kick personal and life goals, both on and off the field.”
The JMF program is community driven, with children supported to attend school and make healthier lifestyle choices.
The expanded program will focus on primary health through:
- Nutrition programs, with meal plans developed by a sports dietitian;
- Mental wellbeing, through emotional self-regulation training, with coaches focussing on building resilience;
- Community cohesion, through gatherings to support tournaments and holiday clinics encouraging community interest and participation; and
- Parental involvement to enable families to improve health through physical activity.
JMF Managing Director Ros Moriarty said the Foundation was “extremely grateful” for this “very significant” funding commitment.
“We look forward to replicating our model of football as a powerful tool for wellbeing, supporting resilient, healthier outcomes for young players, their families and communities,” Ms Moriarty said.
NSW and Queensland communities to participate will be selected on the basis of evidence of strong local interest and intention to embrace the program.
“Our game has a deep history of Indigenous participation, and this step will allow us to do so much more to improve health outcomes for Indigenous children,” said Moriarty Foundation Board Member and FFA Board nominee Craig Foster.
“Football has the power to unite the whole community to support opportunity for all young Australians.”
FFA Chief Executive David Gallop said FFA had been a keen supporter of John Moriarty Football for several years.
“Matildas Head Coach Alen Stajcic has visited Borroloola on a number of occasions and scouted Shay Evans back in 2014,” he said.
“This announcement will help achieve our vision of involving more Indigenous Australians in football, as players, coaches, referees and administrators.
“We look forward to working closely with John Moriarty Football to generate significant health and community benefits while offering a pathway for Indigenous footballers to emulate the success of Young Matilda Shay.”
Mr Wyatt said regular sport and physical activity, particularly for young children, has documented and far reaching health benefits.
“It reduces the risk of obesity, increases cardiovascular fitness, promotes healthy growth of bones and muscles, improves coordination and balance, and gives children a greater self-confidence and belief in their abilities, on and off the sporting field,” the Minister said.
“The JMF program has the potential to contribute to Closing the Gap in health equality, education and employment, and positively impact on the high chronic disease prevalence rates among First Nations people.”
The three-year funding will be provided through the Indigenous Australians’ Health Program over 2018–19 and 2020.
Research into HIV stigma revealing
Australia marked World AIDS Day on Saturday December 1, just as new research was released to reveal the enduring challenge of tackling stigma surrounding HIV.
The Stigma Indicators Monitoring Project: People living with HIV by the UNSW Sydney Centre for Social Research in Health (CSRH) was jointly released with The Australian Federation of AIDS Organisation (AFAO).
The new research is part of an overall project tracking social stigma among populations including people living with HIV, men who have sex with men, injectable drug users and people who engage in sex work.
The results of the Stigma Indicators Monitoring Project: People living with HIV are based on a survey of 181 Australians living with HIV. Despite an increase in knowledge and education about HIV/AIDS, research found many people living with HIV/AIDS still face stigma in their day-to-day lives.
“One of the great successes of Australia’s community-led HIV response has been the mobilisation of those most affected, to mount highly effective treatment and prevention programs,” said Professor Carla Treloar, Director of the Centre for Social Research in Health.
“However, our research shows that we still have a long way to go before people living with HIV, sex workers, people who inject drugs, and men who have sex with men are free from the burden of stigma.”
Key findings from Stigma Indicators Monitoring Project: People living with HIV include:
- 74 per cent of participants surveyed have experienced stigma or discrimination in relation to their HIV status in the last year;
- 19 per cent of participants surveyed experienced stigma or discrimination ‘rarely’, 37 per cent experienced it ‘sometimes’, 11 per cent experienced it ‘often’ and seven per cent experienced it ‘always’; and
- More than half of respondents living with HIV reported negative or different treatment by health workers (52 per cent). Most indicated this happened ‘rarely’ or ‘sometimes’ (44 per cent).
The UNSW research also shows the persistence of stigma toward people most likely to be exposed to HIV. In a parallel survey of 1000 members of the general public, 86 per cent indicated they would behave negatively toward people who inject drugs with 28 per cent indicating this would ‘often’ or ‘always’ be the case. The overall level of stigma toward sex workers was 64 per cent. And despite progress against homophobia, 38 per cent of participants said they would behave negatively toward someone based on sexual orientation.
Darryl O’Donnell, CEO of the Australian Federation of AIDS Organisations said: “Advances in medicine, technology and health promotion have powered strong progress against HIV. However, stigma is still with us and it presents a high barrier to HIV prevention.
“The sad truth is that many people do not get tested for HIV because of the stigma that surrounds it. There is a gulf between the modern reality of HIV as an entirely manageable condition and the way people perceive it.
“As we mark World AIDS Day we should challenge the stereotypes that hold back the HIV prevention effort. It’s time to treat HIV as a disease like any other and dispense with judgemental tropes.”
WMA backs WHO in call for more doctor involvement in fighting air pollution
The first World Health Organisation conference on air pollution was held in October-November in Geneva, Switzerland.
In its report on air pollution and child health, the WHO said health professionals should help shape public health policy on reducing the exposure of pregnant women, children and adolescents to air pollution.
The report adds that health professionals are trusted sources of information and guidance and play an important role not only in treating ill health caused by air pollution but also in educating families and patients about risks and solutions and communicating with the broader public and decision-makers.
This role must be amplified, and the broader health sector must become more engaged in preparing a comprehensive approach to addressing this crisis, the Who report states.
“Polluted air is poisoning millions of children and ruining their lives,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus.
“This is inexcusable. Every child should be able to breathe clean air so they can grow and fulfil their full potential.”
The World Medical Association has echoed the call.
Speaking at the WHO conference, Dr Lujain Alqodmani from the WMA welcomed the call and said health professionals must be well informed about air pollution health risks and what measures can be taken to combat the crisis.
One suggestion would be to follow the example of Kuwait University, which has included air pollution as a main environmental health determinant in its medical curriculum.
She said at the WHO conference that the whole health workforce needed to be equipped with the right skills to address air pollution health risks as part of the initial clinical patient evaluation.
Medical education institutions should produce advocacy teaching materials about air pollution and health and be accessible through online tools to health workers and implemented by health care institutions.
“Physicians around the world are aware of air pollution. It impacts the quality of life for hundreds of millions of people worldwide, causing both, a large burden of disease as well as economic losses and increased health care costs,” Dr Alqodmani said.
New mental health program tells kids to just be you
Former Prime Minister Julia Gillard has launched a new school-based mental health initiative that aims to give teachers the tools to help students manage their mental health.
The Federal Government has invested $98.6 million.
The program Be You will be delivered by Beyond Blue – of which Ms Gillard is the chairwoman – in partnership with Headspace and Early Childhood Australia.
The program will be rolled-out by Beyond Blue in 6,000 schools and 2,000 early learning services in 2019.
Teachers and educators, including those still in training, will have access to free online courses and materials on mental health and suicide prevention.
The program will also be supported by more than 70 frontline staff from Early Childhood Australia and Headspace who will help schools and early learning services around the country implement the program, through online, telephone, and face to face consultations.
“Half of all lifelong mental health issues emerge before the age of 14,” Ms Gillard said.
“We have the opportunity to grow Australia’s most mentally healthy generation. It’s a big ambition and to achieve it we are asking everybody to get involved.”
Health Minister Greg Hunt said the program will provide Australian teachers with the skills and resources to be able to teach students how to manage their mental health and wellbeing, build resilience, and support the mental wellbeing of other students.
“It will ensure that students have all the support required for healthy social and emotional development,” Mr Hunt said.
“Be You will teach educators to identify any students who may be experiencing mental health difficulties, and to work with the families and local services to get the right help early on. It will also help educators look after their own mental health.”
Education Minister Dan Tehan added that Be You builds on the strengths of current school-based mental health programs, and complements the recently launched Australian Student Wellbeing Framework.
“I encourage all Australian schools and early learning providers to engage with beyondblue and Be You to support the mental health and wellbeing of our students,” Mr Tehan said.
“As half of all mental health disorders in Australia emerge before the age of 14, schools and early learning services in Australia represent one of the best opportunities for mental health issues to be detected early and managed.
“Schools also play a vital role in prevention by helping our children and young people learn the skills they need to look after their own mental health and wellbeing.”
The Government is also providing $2.36 million over four years to the University of Queensland to evaluate the program. This will assess the effectiveness and cost-effectiveness of the program, and identify opportunities to strengthen or improve it.
Effectiveness of a hospital-based postnatal parent education intervention about pain management during infant vaccination: a randomized controlled trial [Research]
BACKGROUND:
Parents have reported that they want to learn how to reduce pain in infants during vaccinations. Our objective was to compare different levels of intensity of postnatal education about pain mitigation on parental self-reported use of interventions at future infant vaccinations.
METHODS:
We conducted a longitudinal, 3-group parallel, add-on, randomized controlled trial on the postnatal ward of a hospital. New mothers, unaware of the hypothesis, were randomly assigned to 1 of 3 intervention groups and 3 follow-up groups (i.e., 9 groups, 3 x 3). The 3 intervention groups were control (general immunization information), pain pamphlet (pain mitigation information), and pain pamphlet and pain video (pain mitigation information). Both pain mitigation education groups also received general immunization information. The 3 follow-up groups were 2-, 4- and 6-month infant vaccinations. Mothers reported use of breastfeeding, sucrose and topical anesthetics during infant vaccinations in a telephone survey.
RESULTS:
Of 3420 participants, follow-up was available for 2549 (75%): 36.1%, 34.2% and 29.7% reported on pain mitigation practices at 2-, 4- and 6-month vaccinations, respectively (p = 0.9). Maternal characteristics did not differ (p > 0.05): mean age, 33.6 years; 58% were primipara. Utilization of any intervention (breastfeeding, sucrose or topical anesthetics) was 53.2%, 61.4% and 63.0% for control, pain pamphlet, and pain pamphlet and pain video groups, respectively (p < 0.001); both pain education groups had higher utilization than the control group, but did not differ from one another. Uptake differed among intervention groups at 2 and 4 months but not at 6 months.
INTERPRETATION:
Hospital-based postnatal education increased parental use of pain interventions at infant vaccinations and can be added to existing education.
Trial registration:
ClinicalTrials.gov, no. NCT01937143.
Inquiry agrees with AMA’s aged care recommendations
A Parliamentary Committee report has accepted many of the AMA’s recommendations on how to improve the care of vulnerable Australians in residential aged care facilities, including the need for more registered nurses.
AMA President Dr Tony Bartone, who appeared before the Inquiry in May, said that the recommendations of the Report on the Inquiry into the Quality of Care in Residential Aged Care Facilities in Australia largely align with AMA policy.
“It is critical that residents in aged care facilities, and the doctors visiting them, have access to appropriately trained staff at all times,” Dr Bartone said.
“The AMA has been advocating for a registered nurse-to-resident ratio that aligns with the level of care need, and ensures 24-hour registered nurse availability.
“The Committee has recommended that it be enshrined in law that all residential aged care facilities provide for a minimum of one registered nurse to be on-site at all times.
“This is a good first step. However, we recognise that one registered nurse will not be enough in many residential aged care facilities, which may have hundreds of frail residents.
“We are pleased that the Committee has further recommended that the Government specifically monitor and report on the correlation between standards of care, including complaints and findings of elder abuse, and staffing mixes to guide further decisions in relation to staffing requirements.
“In the most recent survey of AMA members who visit patients in residential aged care, more than one in three doctors said that they plan to cut back on or completely end their visits over the next two years, citing a lack of suitably trained and experienced nurses, and inadequate Medicare patient rebates.
“Our members are also concerned about the trend to replace registered and enrolled nurses with personal care attendants, who are not appropriately trained to deal with the health issues older people face.
“The Committee has acted on these concerns, recommending that the Government review the Medicare rebate for doctor visits to residential aged care facilities, and a review of the Aged Care Funding Instrument (ACFI) to ensure that it is providing adequate levels of care for the individual needs of aged care recipients.
“The AMA also notes the recommendation to improve the Community Visitors Program to ensure volunteers visiting aged care facilities are better able to respond to suspected abuse. The AMA Position Statement on Health and Care of Older People 2018 called for education and training programs on the recognition, intervention, and management of elder abuse.
“While we have a Royal Commission, the AMA still urges the Government to act as a matter of urgency in responding to the many reviews that have now been completed. We have seen too many cases of abuse and neglect to delay action any further. The need for access to appropriate quality care cannot continue to be left unaddressed.”
LUKE TOY and MARIA HAWTHORNE
The AMA Submission to the Inquiry into the Quality of Care in Residential Aged Care Facilities in Australia is at submission/ama-submission-house-representatives-standing-committee-health-aged-care-and-sport-%E2%80%93
The AMA Position Statement on Resourcing Aged Care 2018 is at position-statement/aged-care-resourcing-2018
The AMA Position Statement on Health and Care of Older People 2018 is at position-statement/health-and-care-older-people-%E2%80%93-2018
The AMA Submission to the Department of Health’s Draft Charter of Aged Care Rights is at submission/ama-submission-department-health-%E2%80%93-draft-charter-aged-care-rights
The AMA Aged Care Survey is at article/2017-ama-aged-care-survey
The AMA Position Statement on Health and Care of Older People 2018 is at position-statement/health-and-care-older-people-%E2%80%93-2018
The AMA Submission to the consultation on the Terms of Reference for the Royal Commission into Aged Care Quality and Safety is at submission/ama-submission-department-health-terms-reference-royal-commission-aged-care-quality-and
[Articles] Measuring human capital: a systematic analysis of 195 countries and territories, 1990–2016
Countries vary widely in the rate of human capital formation. Monitoring the production of human capital can facilitate a mechanism to hold governments and donors accountable for investments in health and education.