AFPHM eBulletin – 14 December 2018

Member Spotlight: Dr Marisa Gilles

Have you ever wondered how the arts could be used to improve health? Or how public spaces could be transformed to support the health of the local community?

From developing innovative intervention programs to working on the forefront of disease control, Dr Marisa Gilles, Public Health Physician at the Western Australian Department of Health, shares her breadth of local and international public health experience with us below. 

Why did you choose public health medicine as a career? 
It chose me – I was working at the coal face as a Royal Flying Doctor in Alice Springs and I became dissatisfied with the reactive medicine I was doing and decided to complete a Master in Applied Epidemiology to try and get a better perspective. This led to choosing Public Health as a career as it seemed to provide a big picture and politically active way forward, to really make a difference.

What does your current work involve? 
I still have some clinical practice and individual people interaction. But the majority of my job involves classic disease control activities, advocacy, action planning and policy development in the fields of sexually transmissible diseases (STIs) and blood bourne viruses (BBVs), teaching and mentoring junior doctors, GPs, other health professionals and public health registrars, and carrying out some research.

What aspects of your job get you out of bed each morning? 
A mixture; not really knowing what the day might bring makes the days interesting.  I do enjoy the disease control excitement; responding in a timely way and doing the media demands that result. I also enjoy my patients and I love sharing my knowledge and teaching.

What are your main interests in the field? 
Prison health, Aboriginal health, STI and BBVs.

In what ways have you used art to improve health?
I think the positive benefits of art are underrated. I believe that the process of developing a play, or mosaic or mural, or video are significant. 

In 1999, my team carried out a program called 'photo voice' where cameras were given to children and they were asked to take photos that had an impact on them, and a short description of why they took the photo. The results were amazing – they took a photo of the basketball court being locked, of rubbish that they hated and of fighting that sometimes is overwhelming.

In 2000, my team of Aboriginal and non-Aboriginal staff wrote a play called 'living with HIV not dying with AIDS'. It aimed to counter the old belief that HIV meant AIDS and death, it was a story about a young HIV positive girl and her relationship with her family and her partner, with whom she has a child with. Her partner and her baby are negative as she is on medication. The play deals with safe sex, confidentiality and hope. It was presented on World AIDS day. This play was also taken to schools where children acted in the various parts and asked questions regarding safe sex and HIV from reading the script.

In 2017, I was involved in the making of a video around timely testing and treatment for STIs in a town called Meekatharra to promote testing. It is on YouTube, titled ‘Welcome to the MK nation’ (check it out). It was so fantastic to see the young people write the song and become engaged in the development of the video better than any one-off event. 

What has been the most rewarding part of your career to date? 
Definitely when I was the Director of Public Health for the Gascoyne region. In this role I felt I could make a difference. My team were fantastic and quite diverse, with 30 per cent Aboriginal staff. Reconciliation was a public health aim in our business plan, we also developed health promoting environments, such as improved public open space in the parts of town where more Aboriginal people lived. We started a farmers market to provide cheap high-quality fruit and vegetables to the community and developed a men’s health promotion intervention called PitStop, which used the theme of car maintenance to screen and advise men on their health – fuel injectors tested alcohol use, testicular examination was spark plugs, ducco was skin examination etc.

How has your experience working in public health overseas shaped your work in Australia? 
It has helped in a few ways; first it makes me realise how much we have in terms of resources and social freedom from war, hunger and real poverty. Secondly, it reinforces the importance of good data and surveillance in guiding resources where they can make the most impact and finally it has given me confidence in my abilities and rejuvenated me and my passion to make a difference.

What advice do you have for trainees who are starting their career in public health medicine? 
To make sure they take every opportunity to gain a wide range of skills, keep open to all possibilities, create relationships both within and outside of the discipline and value all the expertise in their teams, not just the doctors. Be flexible and be creative, public health is so much more than medicines and hospitals that’s what makes it so interesting and rewarding. 

A message from your President

Hello from Poland where I’m attending the United Nations Framework Convention on Climate Change (UNFCCC) Conference of the Parties 24 (COP24) on behalf of the RACP. Three years ago in Paris, world leaders signed the Paris agreement, which was an important step forward in global cooperation towards limiting carbon emissions and adapting to climate change. At COP24, world leaders or their representatives aim to agree on a rulebook that will set out the details of implementing the Paris agreement. Yes, things move frustratingly slowly in international negotiations. There are various components of the Paris agreement, and of the rulebook, and these include how contributions to financing and emission reductions will be reported; as well as details of what should be included in the National Determined Contributions (NDCs) to the Paris Agreement. This may seem to be rather dry, but it is critically important in terms of actually implementing the agreement. At the COP there are a lot of discussions about what should and should not be included in the rulebook, including health, human rights, and Indigenous rights. 

I’m part of a smallish delegation of health people who are trying to increase the profile of climate change and health at the COP. The hope is that by drawing attention to the impacts of climate change on health as well as the health benefits (and subsequent cost savings) of climate change mitigation, world leaders might increase their ambition in emissions reduction. To that end the President of COP23 asked the World Health Organization (WHO) to develop a special report for COP24. This report, ‘Health and Climate Change’, was launched at the COP last week. In addition the Global Climate and Health Alliance hosted a Climate and Health Summit on 8 December. Also at the COP, Arnold Schwarzenegger did a joint presentation with Dr Maria Neira, Director of Public Health and the Environment, WHO. Mr Schwarzenegger spoke about the health impacts of climate change as well as the co-benefits of mitigation. Apart from reducing air pollution, he specifically mentioned physical activity as a co-benefit from using cars less. The visibility of health in the international climate change negotiations is increasing over time, thanks to the work of a lot of people, including our former President, Professor Lynne Madden. 

The Lancet Countdown Australian report was released on 29 November. The RACP was represented by Professor Tony Capon, who spoke at the launch. It is well worth reading, as is the global Lancet Countdown report.

Associate Professor Linda Selvey
President, AFPHM 
 

Register for RACP Congress 2019

Join colleagues from Monday, 6 to Wednesday, 8 May 2019 at the Aotea Centre in Auckland, New Zealand, for RACP Congress 2019. 

Register now to attend the AFPHM session on rural and remote populations and health issues. Australians and New Zealanders living in rural and remote areas generally experience poorer health outcomes than people living in metropolitan areas. They have higher rates of chronic disease and mortality, poorer access to health services and are often more likely to engage in behaviours associated with poorer health. AFPHM have invited speakers who have worked in rural and remote areas to discuss the various factors impacting these populations and how physicians can be better supported to achieve higher health outcomes for these populations. 

RACP Congress 2019 key topics include:

  • Life course theory ‘How do we impact health along the life course?’
  • Obesity: rising to the challenge
  • First 1000 days and non-communicable diseases
  • Medically unexplained symptoms master class
  • Mental health and addiction of patients
  • Chronic disease and integrated care

Early bird registration closes 22 February 2019.

Visit the Congress website to register and view the program. 

RACP holiday closure

The RACP will be closed over the Christmas and New Year holiday period from Monday, 23 December 2018 through to Wednesday, 2 January 2019 in Australia and Thursday, 3 January 2019 in New Zealand. 

Happy holidays.

Seeking AFPHM representatives for committees

Are you willing to represent your colleagues and be a voice for the Faculty? Would you like to be part of creating positive change within the Faculty? 

The Faculty is currently seeking Expressions of Interest for the following positions on: 

Lead Fellow reminder

Expressions of Interest are sought from Fellows interested in nominating for the RACP Congress Lead Fellow role for 2020, with the possibility of extending to 2021.

The Lead Fellow and the Congress Planning Committee work with key stakeholders to implement the Board’s strategic vision for Congress.

Find out more

Accredited AFPHM training positions

As a part of the AFPHM training program, trainees are expected to complete their core training in an AFPHM accredited training position.

A list of accredited AFPHM training positions is available on the RACP website.

CPD funding on offer  

Fellows in rural and remote Australia are invited to apply for funding to undertake CPD activities, as part of the Support for Rural Specialists in Australia program.

Read more

Listen to our targeting diabetes podcast  

Dr Paul Drury and Professor Sophia Zoungas discuss issues surrounding pharmacological management of Type 2 diabetes in the latest Pomegranate Health podcast. 

Listen now

Workshops to promote participation from Aboriginal and Torres Strait Islander women in the National Cancer Screening Program 

Around 55 workshops (free of charge to workshop participants) will be delivered across Australia in 2018 and 2019. The workshops aim to support healthcare providers and other relevant groups to promote cervical screening and the benefits of regular cervical screening to Aboriginal and Torres Strait Islander women, in accordance with the renewal changes.  

To register, or for more information on the workshops, please contact The Benchmarque Group on telephone 1300 855 568 or by email at courses@benchmarquegroup.com.au

Newly released report on reducing opioid-related harm for surgical patients

The Society of Hospital Pharmacists of Australia's (SHPA) newly released report, Reducing opioid-related harm: A hospital pharmacy landscape, exposes national inconsistencies in the provision of pharmacy services to reduce the risk of opioid misuse, extremely high use of sustained release opioids and poor handover of discharge information for use by general practitioners.

According to SHPA, this is the first Australian study to comprehensively analyse current hospital pharmacy practices around opioids. It has shone a light on the link between the prescribing and supply of opioids to patients after surgery in public and private hospitals nationally and heightened risk of long-term misuse and dependence, highlighting the urgent need for a coordinated, multidisciplinary response.

Medical Board of Australia’s updated sexual boundaries guidelines

The Medical Board of Australia’s (the Board) updated Guidelines: Sexual boundaries in the doctor-patient relationship came into effect on 12 December 2018.

The updated guidelines complement the Board’s Good medical practice: A code of conduct for doctors in Australia and do not change the ethical and professional conduct expected of doctors by their peers, the community and the Board.

The updated guidelines were finalised following wide-ranging stakeholder consultation. The Board appreciates the contribution of stakeholders to the review of the guidelines.

The key changes to the guidelines include:

  • a change in the title to make the scope of the guidelines clearer
  • editorial updates that re-order the content, make it easier to read and clarify terms and definitions
  • a new section on social media that complements the Board’s social media policy
  • a requirement for patient consent if medical students or anyone else is to be present during an examination or consultation
  • advice that an unwarranted physical examination may constitute sexual assault. This includes conducting or allowing others, such as students, to conduct examinations on anaesthetised patients, when the patient has not given explicit consent
  • replacing the term ‘chaperone’ with the term ‘observer’. The revised section on the use of observers reflects the advice and principles in Professor Ron Paterson’s report of the Independent review of the use of chaperones to protect patients in Australia, February 2017.

RACP becoming a supporter of the Global Initiative to End All Corporal Punishment of Children 

The RACP and its Paediatrics & Child Health Division (PCHD) accepted an invitation from the Global Initiative to End All Corporal Punishment of Children to be listed as supporters on the Global Initiative’s website. The Global Initiative campaigns around the world to end corporal punishment of children. It generally seeks to partner with organisations in many countries and has collaborated with the College previously. Its campaign is strongly aligned with established College positions on child protection and physical punishment of children.

Corporal punishment has been illegal in all settings in New Zealand since 2005, but as the RACP is a trans-tasman College, it is now listed as a supporting organisation in Australia as well as New Zealand on an interactive map on the Global initiative’s website

Other supporter organisations in Australia and New Zealand to date are: 

Australia

  • Australian Human Rights Commission
  • Bega Valley Sanctuary Refugee Group
  • Commissioner for Children Tasmania
  • National Children’s and Youth Law Centre.

NZ

  • NZ Human Rights Commission
  • Brainwave Trust Aotearoa 
  • Action for Children & Youth Aotearoa
  • Youthlaw Tino rangatiratanga Taitamariki.

While being a supporter does not entail any financial or other obligations, the College might be listed as a supporting organisation in future Global Initiative publications. 

Boost your genomics knowledge

A new elearning module is available to introduce physicians in Australia and New Zealand to the emerging field of clinical genomics.

Learn more 

Survey of Clinician Researchers – Invitation to participate

The National Health and Medical Research Council (NHMRC) invites all clinician researchers to participate in the 2018 Survey of Clinician Researchers. The survey is being conducted on behalf of NHMRC by ORIMA Research, an independent market and social research company. 

By participating in this survey, you will contribute to research that will inform the NHMRC about:

  • whether there are appropriately clear and supported career pathways available to clinician researchers in Australia
  • factors that enable some clinicians to enter research
  • factors that enable some clinicians to maintain a career in research 
  • factors that cause some clinicians to choose not to enter research 
  • major support mechanisms and enablers for clinician researchers
  • major barriers and current issues for clinician researchers. 

Participation in the project will assist NHMRC in building a better understanding of the clinician researcher population in Australia. The RACP encourages you to participate in this important research as the project will benefit researchers from medical, nursing and allied health disciplines and in the longer term will aid the integration and translation of research into health policy and practice.

Ethics approval was granted for this project by the ORIMA Research Human Research Ethics Committee. 

For more information, or to participate:
1. read the Participant Information Sheet
2. go to the survey website by clicking on the link below, or pasting the link into your browser: https://www.orima.com.au/nhmrc/clinicianresearchers    

If you have further questions regarding the Survey of Clinician Researchers, please do not hesitate to contact May from ORIMA or Alice from NHMRC:

Conferences and events

The Royal Australasian College of Physicians publishes notices of events and courses as a service to members. Such publication does not constitute endorsement or mandating of any such events or courses.

Go to the RACP events list at any time to see what events are coming up.

AFPHM contact details

AFPHM Faculty enquiries (including Council and committees):
Rachel Smith, Executive Officer
Phone: +61 2 9256 9622
Email: afphm@racp.edu.au

AFPHM Education and Training enquiries:
Anusha Kumar, Education Officer
Phone: +61 2 8247 6286
Email: publichealth@racp.edu.au

AFPHM Oral Examination enquiries:
Caroline Greenaway, Examination Coordinator, Assessment and Selection Unit
Phone: +61 2 9256 9681
Email: examinations@racp.edu.au

AFPHM training site accreditation inquiries:
Site Accreditation Unit

Phone: +61 2 9256 9674
Email: accreditation@racp.edu.au

AFPHM CPD enquiries:
Office of the Dean (CPD)
Phone: +61 2 8247 6285
Email: mycpd@racp.edu.au

AFPHM New Zealand enquiries:
RACP New Zealand Office
Phone: +64 4 472 6713
Email: nz_afphm@racp.org.nz
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