Pot-pourri eBulletin 24 July 2020

President's Message

The last few months have been challenging for us all as we navigate our way through COVID-19. We have had to alter our normal work practice but still deliver a high level of care to our patients during a time of great uncertainty and fear. As a profession we often put our own needs last, but it is essential that we take care of our own wellbeing so that we can take care of our patients. This is further explored in a short video with Dr Sarah Dalton FRACP, Dr Lynne McKinlay FRACP and Dr Chris Vagias (Basic Trainee).

As paediatricians, we are acutely aware of the effects alcohol has on an unborn baby. The RACP has been a key player in the media, social media and advocacy campaign urging Australian governments to mandate the evidence-based alcohol labelling scheme developed by Food Standards Australia New Zealand to warn Australians about the dangers of drinking while pregnant.

On 17 July 2020, the Ministerial Forum on Food Regulation made the important and pioneering decision to endorse the warning labels, safeguarding the health and wellbeing of children in Australia and Aotearoa New Zealand. The RACP has been supportive of effective pregnancy warning labels on alcohol products for over a decade – it is impossible to overestimate the positive effects of this critical public health win.

The RACP continues its advocacy work joining Aboriginal and Torres Strait Islander organisations, medical, human rights and legal experts calling for Australian governments to raise the age of legal responsibility from 10 to 14 years of age. This week RACP President-elect Dr Jacqueline Small attended an online panel discussion hosted by the Public Interest Advocacy Centre to discuss this important issue alongside experts across health, law and youth and community service. On Monday, 27 July, the Council of Attorneys-General will meet via videoconference to debate whether states and territories should raise the age of criminal responsibility – this could be a huge turning point for this campaign.

The criminalisation of young children is a nationwide problem and is out of step with international standards. Children aged 10 to 14 years of age lack emotional, mental and intellectual maturity. Each year across Australia, around 600 children under the age of 14 are detained in prison cells. Close to 70 per cent of these children are Aboriginal and Torres Strait Islander children, which is of additional and serious concern.

Adolescents under the age of 14 are undergoing significant physical, psychological and emotional change with attendant consequences on decision-making, organisation, impulse control and recognition of the consequences of their actions. Being subjected to a criminal legal process at such a formative age will adversely affect their health, wellbeing and future. Many children in the youth justice system have high rates of pre-existing trauma and significant additional neurodevelopmental conditions. Holding a child criminally responsible under these circumstances is ethically unacceptable.

The UN Committee on the Rights of the Child has called on countries to raise the age to at least 14 years old and many countries have already taken this step. It is now time for the Australian Government to take urgent action to raise the minimum age of criminal responsibility. May I encourage all members to learn more about the campaign and sign the petition at www.raisetheage.org.au and support #RaiseTheAge on social media where possible.

On a brighter note, nominations are now open for the Howard Williams Medal. The Medal is awarded each year to a member who has made an outstanding contribution to improving the health of children and young people in Australia and Aotearoa New Zealand. Please consider nominating a colleague who meets this criterion. I would also like to remind members that applications are now open for PCHD’s International Grant – Asia Pacific Region.

Clinical Professor Catherine Choong
PCHD President

Telehealth in Australia now

Telehealth was brand new for many of us, and now some of us might be getting rusty on the fundamental considerations to make before, during and after telehealth consultations.

The animation below will be included in a new online learning resource that will be available on eLearning.racp.edu.au and will also include Aotearoa New Zealand specific information.

 

Chapter of Community Child Health webinar series

The Chapter of Community Child Health (CCCH) Satellite Day 2020, normally held with the RACP Congress, was unfortunately cancelled this year due to the COVID-19 outbreak. The CCCH Committee has worked with the College to ensure that, wherever possible, the planned high-quality content will be delivered to all College members via live and recorded webinars.

All College members may access the CCCH Satellite Day 2020 presentations online. Presentations already uploaded include:

Visit the RACP Online Congress Series – you’ll need to log in with your usual RACP login details. Scroll down to the 'Explore Talks' section, then select 'Ancillary' and 'CCCH' to access the CCCH content. If you have any problems accessing the site, please don’t hesitate to contact the College for assistance.

More presentations will be loaded as content becomes available, so bookmark the link above and watch out for regular updates.

Update on the Divisional Clinical Exam (DCE)

The dates for the rescheduled exams for Adult Medicine and Paediatrics & Child Health are now available on the RACP website. These exams will only be for those trainees who were eligible to sit the exam originally scheduled for 2020. Applications will open in August and we will remind all eligible trainees closer to the date.

Trainees who are eligible for the 2020 DCE will receive a survey in the next few weeks to seek expressions of interest to sit the long cases later this year.

We are also currently reviewing the exam dates for Victorian candidates in light of the increase in COVID-19 cases. We will use the trainee survey to help inform this decision.

The 2021 DCE is still on track to be run during its normal timeframes.

Modular approach

To minimise the risks of COVID-19 impacting the rescheduled exam, we’ve changed the way it will be delivered.

The new ‘modular format’ will now be used for all Adult Medicine and Paediatrics & Child Health exam candidates, with the exception of Paediatrics & Child Health in Aotearoa New Zealand who will continue to use the traditional exam format.

Further details on what is involved with the modular approach are available on our website.

Many trainees have asked if the 2020 DCE in its new format will count as an attempt. A decision on this is being considered by various Committees and is imminent and should be announced in the next week.

Congress Online Series

The Howard Williams Medal Oration

The Howard Williams Medal recipient, Professor Louise Baur AM has recorded the Howard Williams Medal Oration as part of the RACP Online Congress Series this year. Professor Baur is a pioneer of the development and provision of clinical services for children and adolescents with obesity and she has championed the need for coordinated healthcare pathways and health professional training in paediatric obesity.

Professor Baur’s oration, Tackling the complexity of child and adolescent obesity focuses on her body of research which has helped define management efforts around childhood obesity and improved our understanding of the factors that help prevent obesity in the first years of life.

Although we are unable to meet face-to-face this year, we have made the Howard Williams Medal Oration available on-demand as part of the RACP Online Congress Series. Please take the time to watch the oration and hear from one of our leading paediatricians.

Calling all artists and performers – the Online Congress Series Fringe Experience

At RACP Congress 2019, we launched the inaugural Fringe Experience. The Fringe Experience provided an opportunity for you to share the things you do outside of your life as health care professionals. We were treated to singing performances, poetry readings, art displays and yoga sessions, highlighting the extraordinary talents of our members and focusing on some of the things you do to look after your health and wellbeing.

Although we are unable to meet face-to-face this year, we are still excited to bring you the Online Congress Series Fringe Experience.

Are you a budding musician, singer, dancer or mime artist? Send us a short video that we can share on the Online Congress Series platform.

Do you dabble with paints, pencils or crayons? Send us a picture of your artwork to include in our Fringe Experience Gallery on social media

Perhaps you have an eye for photography. We would love to share your work.

The Online Congress Fringe Experience will include meditations, yoga sessions, creative writing workshops and more.

If you would like to lead a session, showcase your art or share a performance email racpcongress@racp.edu.au with a short synopsis of your presentation. We will work with you to bring your ideas to life.

Join the new College Learning Series Committee

We are looking for PCHD Fellows and trainees to join the newly established College Learning Series (CLS) Committee for Paediatrics & Child Health. Applications for the following voluntary roles are now open:

  • Bi-national Coordinator
  • Deputy Bi-national Coordinator
  • Regional Coordinators (multiple roles)
  • Trainee representatives (two roles).

Following the success of the adult medicine stream of the CLS, the Paediatrics & Child Health Division Education Committee (PDEC) established the CLS Committee (Paediatrics & Child Health) to identify lecturers and facilitate the production of CLS lectures that reflect the PCH Basic Training curriculum. This new committee will develop an annual schedule of lectures and work to ensure that the schedule is delivered, with support from dedicated CLS staff in the College.

Interested Fellows are encouraged to apply, or to recommend the positions to suitable colleagues.

If you are interested in being a part of this process, please apply via the RACP website.

Queries can be directed to the Program Manager, Mike Davidson via email.

Applications close Friday, 31 July 2020.

Join the College Policy and Advocacy Council Executive Committee

Do you want to be a force for change and be recognised and listened to by health policy decision-makers and be an advocate for patients’ interests? Apply to be a member of the Executive Committee for our College Policy and Advocacy Council.

There are seven vacant positions open on the College Policy and Advocacy Council Executive Committee (CPAC EC). Members of the CPAC EC make a real difference by tackling emerging policy and advocacy issues to improve the quality and safety of healthcare in Australia and Aotearoa New Zealand.

Find out more

Presentations for the 2020 Rue Wright Memorial Award go virtual

Save the date: Wednesday, 19 August 2020

There will be five candidates competing for the 2020 Rue Wright Memorial Award presented to the applicant who best demonstrates excellence of hypothesis, scientific merit and relevance to community child health in an oral presentation. These presentations are normally made at the RACP Congress but will now be made via webinar.

The Award is named in honour of Dr Rue Wright who was a significant founder of The Australian Child Health Medical Association (ACHMA). Founded in 1984, ACHMA was the first Australian association of community child health doctors.

Register your attendance

Howard Williams Medal

Don’t miss the opportunity to nominate a colleague for the Howard Williams Medal which recognises a member of the Paediatrics & Child Health Division who has made an outstanding contribution to improving the health of children and young people in Australia and/or Aotearoa New Zealand. Nominations close on Monday, 10 August 2020.

College Medals and Awards

Nominations are now open for the following College Prizes which acknowledge outstanding contributions and achievements made by Fellows and trainees in their respective fields:

  • The John Sands Medal recognises a Fellow who makes a significant contribution to the welfare of the RACP and its members.
  • The College Medal is aligned to the College motto 'Hominum servire saluti'. It is awarded to a Fellow who makes a significant contribution to medical specialist practice, healthcare and/or health of community through physician activities.
  • International Medal recognises a member who has provided outstanding service in developing countries.
  • Medal for Clinical Service in Rural and Remote Areas recognises a Fellow who has provided outstanding clinical service in rural and remote areas of Australia or Aotearoa New Zealand.
  • Mentor of the Year Award recognises a Fellow who has made an outstanding contribution to mentoring or provided a high level of support and guidance throughout training.
  • Trainee of the Year recognises a trainee who has made an outstanding contribution to College, community and trainee activities.
  • The Eric Susman Prize is awarded by the College to a Fellow for best contribution to the knowledge of internal medicine.

Successful nominees are presented a medal at the RACP Congress.

Full details are available on the RACP Foundation webpage.

Trainee Research Awards 2020

Applications for Trainee Research Awards are now open for trainees and new Fellows undertaking post-Fellowship training.

The Trainee Research Awards provide a valuable opportunity for trainees to present their research at an Australian regional or Aotearoa New Zealand event. The best presenters from each local event are invited to be part of the Research and Innovation stream at the RACP Congress. Selected representatives will also receive complimentary registration, return airfares, and accommodation for up to three nights to attend the RACP Congress.

Please send your abstract submissions or inquiries by email to your respective regional RACP offices. Applications are due Monday, 31 August 2020.

RACP a key player in the historic decision on pregnancy warnings on alcoholic products

On 17 July 2020, the Ministerial Forum on Food Regulation made the important and pioneering decision to endorse evidence-based pregnancy warning labels on alcohol products, safeguarding the health and wellbeing of children in Australia and Aotearoa New Zealand. The College has welcomed the Ministerial decision to adopt effective pregnancy warning labels on alcohol products.

The evidence-based labelling scheme recommended earlier in the year by Food Standards Australia and New Zealand was finally endorsed by a majority of ministers after a more than decade-long campaign for mandatory, clear and effective labelling of alcoholic products with warnings that indicate drinking while pregnant harms the unborn baby.

Special thanks in this long, coordinated campaign go to Professor John Wilson, Associate Professor Mark Lane, Professor Elizabeth Elliott, Dr Adrian Reynolds, Dr George Laking, Professor Judy Savige, Dr Rajesh Raj and Associate Professor Nick Buckmaster, as well as to our dedicated partners at the Foundation for Alcohol Research and Education. It’s truly impossible to overestimate the positive effects of this critical public health win.

In the words of Professor Elliott, “The colour of this label is particularly important. Red attracts attention and conveys warning, the black text on white background is easily legible, the pictogram is understandable even by non-English speaking populations, and the words ‘alcohol can cause lifelong harm to your baby’ give a clear warning message.”

As Professor Wilson stressed, “The RACP has been supportive of pregnancy warning labels on alcohol products for over a decade – it’s great to see Australian and New Zealand governments now take this necessary step for the health of our communities.”

Helpful resources for adolescent and young adult medicine

The health needs of adolescents and young adults are very specific, and paediatric and adult medicine physicians alike may find themselves in the position of needing direction about how to deal with some cases they are presented with. The College, with the expert contribution of the Adolescent and Young Adult Medicine Committee, has developed a number of valuable resources available on the RACP website. Links to these resources follow; we recommend bookmarking these for future use.

Landing page of the Adolescent and Young Adult Medicine specialty

Landing page of the Paediatrics and Child Health Division – this page will provide a brief history and outline of the specialised field of adolescent and young adult medicine, as well as a link to the Working with Young People online resource. Other position statements may be sourced via the College’s PCHD Policy and Advocacy page.

College elections have recently seen a refresh of the Adolescent and Young Adult Medicine Committee, and the new committee is keen to finalise other position statements currently in development – these will be made available via the above link as soon as possible. Watch this publication for further announcements.

Last but not least, don’t forget the College’s Curated Collections. Use your RACP login to access the Adolescent and Young Adult Health Curated Collection. This collection has been peer-reviewed by Fellows of the RACP to help you find high-quality resources on adolescent and young adult health, development and wellbeing, all of which can be claimed for CPD credits.

If you have any questions about or suggestions for the work of the Adolescent and Young Adult Medicine Committee, please email Paed@racp.edu.au.

Prioritising Health 2020 Northern Territory election statement

The Northern Territory Regional Committee has developed an election statement to identify and advocate for its priority areas.

The statement makes NT-specific recommendations on the following priority areas, drawn from existing approved College positions:

  • climate change and health
  • alcohol
  • Indigenous health
  • acute rheumatic fever (ARF) and rheumatic heart disease (RHD)
  • raising the age of criminal responsibility.

This statement is designed to position the Committee and the RACP for post-election advocacy on these priorities over the next four-year term. 

Hotline for health professionals caring for people with disabilities during COVID-19

The Australian Government Department of Health has set up a telephone advisory service providing specialised clinical advice for health professionals involved in the care of people with disability during the COVID-19 pandemic.

Some people with disability may become very anxious in these situations and require reasonable adjustments to their healthcare to ensure they receive either COVID-19 testing or treatment with minimum distress.

Health professionals can call the service on 1800 131 330 between 7am to 11pm (AEST), seven days a week.

Thank you to RACP Fellows who are involved in this service.

Recent changes to the National Immunisation Program

From 1 July 2020, additional at-risk groups will be eligible for funded vaccines under the National Immunisation Program.

Changes relate to the following vaccines:

  • Pneumococcal vaccine (Pneumovax 23 and Prevenar 13) – there are changes to the timing and type of pneumococcal vaccine for some at risk groups, adults and Aboriginal people.
  • Meningococcal B vaccine (Bexsero) – this vaccine is now funded for Aboriginal children and some at risk people.
  • Meningococcal ACWY (Nimerix) – this vaccine is now funded for some additional at-risk people.
  • Haemophilus influenzae type b (ACT-Hib) – this vaccine is now funded for some additional at-risk people.

For further details on the changes, please visit the NSW Health website.

New Pomegranate podcast: Ep60 and Ep61: Delirium

Detection and Causes: In the first part of these podcasts 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. 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 hear Adam Kwok describe his experience as the carer of a patient going through the trauma of three bouts of delirium, and the challenges of care.

Prevention and Management: In the second part we discuss 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, though there are no medications indicated for treatment anywhere in the world. Antipsychotics should only be considered in patients experiencing severe distress intractable by other means as they are associated with many adverse side effects.

Guests

  • Adam Kwok
  • Professor Meera Agar FRACP FAChPM (Liverpool Hospital, UTS)
  • Professor Gideon Caplan FRACP (Director of Geriatric Medicine, Prince of Wales Hospital, UNSW)

Fellows of the RACP can claim CPD credits via MyCPD for listening to this episode and reading the resources.

Subscribe to Pomegranate Health in Apple iTunesSpotify or any Android podcasting app.

Listen to Ep60: Delirium Part 1- Detection and Causes

Listen to Ep61: Delirium Part 2- Prevention and Management

Sleep Literacy in Australian Health Professionals

Inadequate sleep is a significant public health issue. A recent parliamentary report (Bedtime Reading) recommended that the Australian government assesses the sleep knowledge of health professionals and develops effective training mechanisms to improve the knowledge of primary healthcare practitioners in diagnosing and managing sleep health problems. Fully qualified medical practitioners are invited to participate in this research study, which aims to survey knowledge, practices, and attitudes towards sleep in Australian Health Professionals. For more information please contact the Chief Investigator Dr Cele Richardson on +61 8 6488 3141 or via email.

To participate in the study, visit the website.

Participants will gain access to a sleep toolkit, which may assist with the management of sleep in their clinical practice. Approval to conduct this research has been provided by the University of Western Australia, in accordance with its ethics review and approval procedures.

Journal of Paediatrics and Child Health

An early view of future articles is now available.

International Pediatric Association (IPA) Newsletter

Access the latest edition of the International Pediatric Association (IPA) Newsletter Year 2020 Volume 14, Issue 2 online.

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

Pot-pourri submissions welcome

To submit an article for publishing in Pot-pourri, please email paed@racp.edu.au. The article should be no more than 350 words. If you would like to submit an image with your article, it would be assumed that you have received appropriate permission to use the photo and it needs to be of high resolution, above 300 dpi. Please note that articles may need to be edited by the RACP Communications Team.

Update your details with the College

Did you know that you can now update your address details online? Simply Login to MyRACP and go to 'Edit my details'.
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