e-news 12 Mar 2010
Welcome to NWQPHC's electronic newsletter! Each Friday we will email a link to the latest news and updates. If you would prefer your update to be faxed, please contact your local Practice Support Officer
- Spike in Aboriginal / Torres Strait Islander infectious syphilis notifications in North Queensland
Alert from Dr Patricia Fagan, public health physician – sexual health, at the Cairns Public Health Unit. Public health authorities (more) - A statement from Sexual Health
I am pleased to announce that Lymphogranuloma venereum (LGV)-specific PCR testing is now available from Pathology Queensland (more) - Advance Health Directives (AHD).
An Advance Health Directive is a legal document stating a patient’s wishes for their care when they no longer have capacity to (more) - Postgraduate Community Aged Care Nursing Scholarship Scheme (more)
- Changes to East Coast Staff
I am please to advise that our new Team Leader Pania Brown commenced this week in the East Coast Office replacing David Brandts-Giesen who (more) - Chronic Disease Strategy Unit Video Conference Seminar Series Invitation - Point of Care Testing (POCT)
The next Chronic Disease Strategy Unit Video Conference to be held on 26 March, 2010 at 2.00-3.00pm (more) - Allied Health Visits (more)
- Health Services Newsletters (more)
- Education and Training Opportunities for this Month (more)
- Spike in Aboriginal / Torres Strait Islander infectious syphilis notifications in North Queensland
Alert from Dr Patricia Fagan, public health physician – sexual health, at the Cairns Public Health Unit. Public health authorities ask medical practitioners and remote area nurses to be on the look out for syphilis – not only among patients who are men who have sex with men (MSM), but also in young heterosexual Aboriginal / Torres Strait Islander men and women throughout the region.
Data from the Queensland Health syphilis surveillance system show that while the recent outbreak of syphilis among MSM appears to be steadying, the number of young Aboriginal / Torres Strait Islander people from urban and remote settings in north Queensland who are being diagnosed with early infectious syphilis, has increased markedly in the last few months. Medical officers and other health care providers must be alert to a possible diagnosis of syphilis in Indigenous young people who are sexually active. Many of these clients are presenting to general practitioners and remote area clinics with genital ulcers or a generalised rash. Diagnosis and treatment is frequently delayed either because syphilis is not considered in the differential diagnosis or treatment is postponed until pathology results become available. Syphilis should always be considered in a young sexually active patient with a rash and/or mucosal ulceration, especially of the genitals. The Queensland Health Sexual Health Guidelines (www.health.qld.gov.au/sexhealth) and the Primary Clinical Care Manual both recommend that such presentations are treated at initial presentation with benzathine penicillin 1.8 gm IMI stat. If cost is an issue, advise the client they can receive free treatment at any sexual health clinic or remote area health centre. It is also important to test for syphilis in clients who have been diagnosed with another STI as infectious syphilis is frequently asymptomatic. Contact tracing should be initiated at presentation or earliest opportunity. Ideally, contacts should be treated at their first presentation as per the above guidelines. Contact your nearest sexual health clinic or remote area health centre for assistance with contact tracing.
For assistance with contact tracing issues, call your local contact tracing officer:
Monica Buhrer-Skinner – Ph 07-4778 9600
Based in Townsville (covering Mackay, Townsville, Mt Isa Districts)
Joanne Leamy – Ph 07-4050 6205
Based in Cairns (covering Cairns & Hinterland, Cape York, T&NPA Districts)
Further information and advice regarding syphilis is available from:
• The Syphilis Register on 1800 032 238
• Cairns Sexual Health Clinic 40 506205
• Townsville Sexual Health Clinic 4778 9600
• Mackay Sexual Health Clinic 49683919
• Mt Isa Sexual Health Clinic 47444805
Information regarding sexual health is available on the following web sites:
• For adults and clinicians: http://www.health.qld.gov.au/sexhealth
• For young people; http://www.health.qld.gov.au/istaysafe
- A statement from Sexual Health
I am pleased to announce that Lymphogranuloma venereum (LGV)-specific PCR testing is now available from Pathology Queensland – Central Laboratory (RBWH). The following information has been provided by Doctors Stuart Aitken, Graeme Nimmo and Theo Sloots which may be useful to consider:
LGV is an STI caused by L1, L2 and L3 serovars of Chlamydia trachomatis. This infection is chronic which progresses through a series of stages including:
Stage 1: the appearance of a small, painless ulcer, often accompanied by inguinal lymphadenopathy; the primary lesion may remain unnoticed.
Stage 2: is characterised by further lymphadenopathy and proctitis that is frequently severe.
Stage3: is characterised by scarring of lymphatic vessels, elephantitis, and a stricture of the anorectum: all of which are refractory to medical treatment and only partially responsive to surgical intervention.
LGV testing should be performed as a secondary test for all confirmed Chlamydia trachomatis rectal isolates, and for their sexual partner(s). There may also be a place for this type of testing amongst people with regional adenitis syndrome, and in the occasional individual with atypical genital ulceration. Occasionally, a repeat LGV test would be conducted, as a test of cure, for those people who were treated with azithromycin. With the onset of some recent case reports of LGV causing the inguinal ulcer-adenopathy syndrome, consideration may be given to also testing MSM with urethral chlamydia for LGV in the future. If an LGV test is indicated you will need to request it as it is not offered automatically. Rectal and/or anal swabs are the only specimen types tested and only if the chlamydia PCR is detected. Tests will be batched once a week. An LGV test can also be requested over the phone if a swab is positive. To make contact with the laboratory phone the duty consultant on: 0437 082 545. The price of this test will be added to the fee schedule so you pay as you go (as for your current test requirements).
- Advance Health Directives (AHD).
An Advance Health Directive is a legal document stating a patient’s wishes for their care when they no longer have capacity to make decisions for themselves. It can be made by anyone age 18 and over and is often made when the person has had a new diagnosis such as cancer, but can be made at any time as long as the person has capacity. The forms are available and can be printed from the web at http://www.justice.qld.gov.au/files/Guardianship/advancehealthdir.pdf. Sometimes patients may come to the GP to ask them to fill out and sign the Doctors section (section 5) and the patient has to sign in the Doctors presence. The doctor needs to be of the opinion that the patient understands what they are signing. When a patient no longer has capacity, an AHD is the first port of call for guidance if it has been done and is available. After this, in order of priority, are a Guardianship Order, if in place, an Attorney for Personal and Health Matters (EPOA), if appointed, then the Statutory Health Attorney. The Statutory Health Attorney is an automatic appointment under law and will be, again in order of priority, spouse, unpaid carer, family member, or close friend. If none of these are available, the Adult Guardian can be consulted as a last resort. As a matter of routine the palliative care team ask patients referred to Palliative Care if they have an AHD and help them to start the process if not. After the Doctor has signed it a Justice of the Peace (JP), a Commissioner for declarations or a solicitor have to witness it and then the patient keeps it in a safe place to produce it when needed. Certified copies can be made but the witness has to sign every page. However AHD’s are not compulsory and often just form a good basis for discussion amongst family members. The tick boxes on pages 11 and 12 (section 3, questions 8,9,10 and 11) are onerous for many people and actually do not have to be completed in full and can be ignored, scored through and initialled. The important points for palliative care patients are particularly those on page 9 (section 3, question 7). AHD’s can also be produced to the Ambulance staff as a way of preventing inappropriate resuscitation. The AHD does not cover such legal issues as blood transfusions in Jehovahs Witnesses. Please phone the Palliative Care Service if you have any questions. Polly Adams, Community Doctor, Palliative Care Department, Townsville Hospital: 47964260
- Postgraduate Community Aged Care Nursing Scholarship Scheme
Overview
The Postgraduate Community Aged Care Nursing Scholarship Scheme is an Australian Government initiative to encourage more registered/division 1 nurses to enter (or re-enter) the community aged care sector, and increase the skills of registered/division 1 nurses already working in the sector.
Application dates
This Scheme is currently open, and the application period will close Friday 16 April 2010.
How to Apply
Please download and complete the Postgraduate Community Aged Care Nursing Scholarship Scheme Application form:
Postgraduate Community Aged Care Nursing Application and Guideline form (187 KB)
The completed form can be sent to the following address by Friday 16 April 2010:
Postgraduate Community Aged Care Nursing Scholarship Scheme
Royal College of Nursing, Australia
PO Box 219
Deakin West ACT 2600
Value of scholarship
Applicants may apply for funding towards more than one activity.
A. Postgraduate Tertiary Study: up to a maximum of $10,000
Full time study load = $5,000 per six months for one year.
Part time study load = $2,500 per six months for one year.
B. Short Course/Workshop
Applicants can receive up to a maximum of $5,000 per course/workshop.
C. Conference participation:
Applicants can receive up to a maximum of $3,000 per conference.
Criteria
To be eligible for this scholarship, you must:
• be an Australian citizen or permanent resident of Australia
• be a registered/division 1 nurse with a demonstrated history of working in the community aged care sector
• hold a current practicing certificate (or its equivalent) issued by a nurse registration body in an Australian State or Territory
• have attended or be planning to attend a conference within Australia in 2009/2010
• be continuing or commencing postgraduate study within Australia in 2009/2010
- Changes to East Coast Staff
I am please to advise that our new Team Leader Pania Brown commenced this week in the East Coast Office replacing David Brandts-Giesen who returned to private practice. Pania comes to us from Centacare where she was managing outreach teams providing family and relationship counselling. Pania will be making contact with individual practices over the next few weeks to introduce herself.
Our Podiatrist, Natalie Walker has left to pursue clinical work in the more remote areas of Western Australia. We have been fortunate to secure a replacement in a fairly short space of time and will welcome Ruth McKeown who will commence in mid-March with clinical services to commence in late March/early April. We continue to pursue recruitment activities to replace our Physiotherapist, but to date continue to have little success due to a nationwide shortage of Physiotherapists. I will keep you updated should there be any changes.
- Chronic Disease Strategy Unit Video Conference Seminar Series Invitation - Point of Care Testing (POCT)
The next Chronic Disease Strategy Unit Video Conference to be held on 26 March, 2010 at 2.00-3.00pm click here to download flyer. There are a limited number of sites available to dial in so please ensure you have sent through your fully completed site registration form as soon as possible. If there are any issues, please give me a call on 3328 9298 or email Chronic_Disease@health.qld.gov.au.