NEW ENGLAND
CONTENTS
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16 A word from the NEML Chair & CEO ......................................................................3 Latest News Community Needs Assessment ..........................................................5 Practice Nursing Campaign.....................................................................................7 Our Provider Support Officers...............................................................................9 Bowel Cancer Information Evening in Mungindi.................................................11 2014 CPD Calendar.................................................................................................12 GP Synergy Prescribing the right medication for doctor retention ..........................13 Aboriginal Health Snap Shot: The NEML Story Fuel Cards..................................14 Healing the Past Building the Future...................................................................15 From the Dietitian’s Desk......................................................................................16 Book Review Title: Fermat’s Last Theorem. Author: Simon Singh................................18
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A word from the Chair
Chair of NEML Board
Dr. David Briggs We are already well into 2014 and much has happened over the Xmas/New Year period. It has been a difficult period weather wise with widespread drought conditions across our region, and given the stresses and strains that this imposes on our farming and related industries across the region we are mindful of the impact of these circumstances on the health and wellbeing of individuals. Our staff are involved in the provision of services in one way or another and can also provide advice about how and where to gain access to services and help. Our Board is also concerned that if more is required that we should respond appropriately and we remain in touch and are available to stakeholders in this respect. Our Board met in December in Armidale for a day of strategic planning and our Annual General Meeting. From that meeting we have adopted a strategic plan that reflects considerable work over a period of time by both Board members, senior staff, and the collective staff that I think is of high quality and will stand the test of time as being a relevant document. More work is required between staff and the Board to agree on relevant indicators of progress in achieving our strategies and I am sure that we will be successful in this next stage of progress. At that meeting in December we invited a range of local stakeholders to also meet with the Board so that we could ensure good working relationships. The promised reviews into the function and roles of Medicare Locals following the election of the new government are well underway but without any formal announcements of the results of those reviews. Whilst this period of review creates a level of anxiety amongst some I remain optimistic about the outcomes and feel that they will be positive about the way we have performed and about the need to ensure a robust PHC framework to support general practitioners and other PHC providers. The Minister for Health has publicly stated the importance of preventative health and primary health care and in a climate of rising costs in the delivery of acute care services, medicines etc the PHC role increases in importance. It is inherent on all of us who work in the health sector to question how cost effective are current health delivery models and continue to look for more effective ways to use those resources. I am sure that NEML is well placed to respond to those challenges. I would like to take this opportunity to also thank Gae Swain who has resigned her Board membership given her busy life, particularly in local government. We thank her for her wise and practical contributions during our formative stages. The Board has accepted the nomination of Sally Urquhart as a Board member and we look forward to her contribution in this role. Remember that in health care one of the few constants is continuing change, much of which is beyond our control. What is within our control is to govern, manage and deliver health care to our local communities and stakeholders, based on good data, best practices, and that focusses most on those in need. We did this last year, for example, in more than 700 direct support services to health practitioners and more than 9,700 mental health services amongst a whole range of other services. We also delivered significant services to Aboriginal communities that would otherwise have little in the way of services, either directly through our own Aboriginal health workforce or in collaboration with other agencies. The impact of our service delivery will continue to grow. Regards
Dr. David Briggs New England Medicare Local | Page 3
A word from the CEO
Chief Executive Officer
GRAEME KERSHAW I’ve been in a great position recently to look at the stocktake of work that the New England Medicare Local (NEML) does. The organisation submits six monthly reports to the Department of Health about its activities and what has been achieved. We have just submitted our report on the period from 1st July 2013 to 31st December 2013. A few of the results are: • Approximately 15,000 clinical health services were delivered to people in the region. This ranged from allied health services such as physiotherapy and dietetic services to consultant neurosurgery and cardiac (heart) health. In most instances the services were provided at no cost to the patient on referral from their GP. Already in the first six months of the year NEML is on track to provide 50% more clinical services than last year. • NEML also introduced a new service to its very small communities and villages in order to connect people in isolated communities to health care. Three Primary Health Care Nurses commenced in August and the first few months have been about consultation with community members and others to determine local needs and develop a health care plan for small communities. While doing this they still managed to provide over 1300 individual services to people and over 90 group sessions on health promotion. • There is a large indigenous population in the region with over 10.5% of the population identifying as Aboriginal. NEML is responsible for a range of services to Aboriginal people under the banner of Closing the Gap on indigenous health disadvantage including programs in Drugs and Alcohol, Primary Health Care, Mothers, Babies and Fathers, health and chronic diseases. • Over 10,000 occasions of service have so far been provided under these services from the Aboriginal Health team. Forty seven people work in this team and over 80% of them are Aboriginal (28% of the NEML workforce identifies as Aboriginal.) • 34 GPs referred to a program to address chronic disease needs of Aboriginal people which led to: 882 allied health services 362 medical specialist services 174 accommodation services (for people needing to travel to specialist care) 582 medication packs (to help people manage their medicines better) 748 transport services (to connect people in the community to the health services they need) o The communities that received these services included - Moree, Wee Waa, Narrabri, Gunnedah, Tamworth, Werris Creek, Quirindi, Walhallow, Walcha, Armidale, Uralla, Guyra, Inverell, Tingha, Glen Innes, Tenterfield, Ashford, Boggabilla, Toomelah o o o o o
New England Medicare Local | Page 4
NEML is also pleased to provide support to GPs and other primary health care providers in the region. During the last half of last year we provided or facilitated an extensive range of education and training services to health practitioners from all disciplines. In total, at all events, there were 255 GP attendances, over 350 nurse attendances and over 220 allied health, general practice staff and other health professional attendances. All of the events were evaluated through the health professions’ quality frameworks. NEML also has a Health Workforce Development strategy and five new General Practitioners and three medical specialists were successfully recruited and supported into the region through collaboration with Hunter New England Health in the 6 month period. Medicare Locals (whether you agree with the name or not) do things that make a difference to people’s health and to their lives. We often do this in conjunction with others who have the same objectives: general practices, Aboriginal Health Services, the Local Health District and other Non Government Organisations. Whether we do it alone or in combination with others we are providing services to the people in our region. Its good to know that someone in a small town waiting for a hip replacement is able to get physiotherapy because of what we do; that an Aboriginal person with diabetes has better blood chemistry this year than they did last year because they are linked in to better care; that the arthritis specialist now visits Narrabri; that nurses in Primary Care have an education network that keeps them informed and connected to one another. And just to make sure that New England Medicare Local is a quality organisation that meets standards, we recently undertook accreditation and although the results aren’t official just yet it looks like we passed. All of our staff worked very hard to make sure that we achieved the grades we did and I’m very pleased with the rewards for their efforts that I’m sure we will soon receive.
Graeme Kershaw
New England Medicare Local | Page
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LATEST NEWS New England Medicare Local is in the process of undertaking its latest Community Needs Assessment. This assessment enables us, as a primary health care organisation, to gauge the community’s knowledge, understanding and perceptions of the types of out of hospital care available for their varying health needs, and areas where more work could be done. This process influences our planning as an organisation and areas of priority. It also helps us to understand whether the data made available to us is an accurate picture of the health of our region. As part of the Needs Assessment Survey, we launched a survey for service providers, community members and health professionals to indicate areas they felt were a priority for the region into the future. Some of the suggested areas were overweight and obesity; smoking, drugs and other harmful substances; chronic disease; and education about health services. If you would like to participate in the survey please visit: www.surveymonkey.com/s/G3YRP79. Alternatively you can contact 02 6766 1394 and a member of staff can talk you through or you can request a hard copy version to fill out and return. Ultimately the results of the survey will enable us to “Improve health in local communities” by helping to coordinate primary health care delivery, and tackling local health care needs and service gaps to “Keep people well and out of hospital”.
AUSTRALIA DAY HONOUR New England Medicare Local Congratulates Dr Peter Wakeford, OAM Dr Peter Wakeford was awarded the honour of the Medal of the Order of Australia in this year’s Australia Day Honours List for his service to medicine. During his career, Dr Wakeford served as a consultant or visiting physician at medical facilities in Armidale, Barraba, Bingara, Collarenebri, Inverell, Quirindi, Tamworth, Walcha, Warialda and Wee Waa. He was also the Chair of the Northern Clinical Council of the Hunter New England Area Health Service between 2005 and 2011. New England Medicare Local | Page 6
They are the most trusted of all professions, so when we at New England Medicare Local found out a number of General Practices around our region were short of Primary Health Care Nurses we sprang to action.
Her colleague Petra Hindley agrees.
A campaign, launched in February, was designed to attract a number of Registered and Enrolled Nurses to General Practice by spruiking the benefits and flexibility the profession offers.
“There is so much flexibility, and obviously no shift work,” she said.
She has been nursing at the same practice for the past 21 years, only stopping for a break when she had her children.
Five nurses working in General Practice, who all love their jobs, were engaged to share the stories of their work and how they are now able to achieve a very healthy and happy lifestyle balance. Inverell Primary Health Care Nurse, Di Leader, began working in General Practice in 2002. Prior to that she worked in acute care as a Nursing Unit Manager at Inverell Hospital. “I felt I needed a change, I had been nursing for a long time and decided to retire,” Di said. “I was approached by a local GP who was looking for some help two days a week and decided to give it a try.” The rest is history. Two days eventually became three and Di is now one of five nurses employed at the Practice where she works. “I love the flexibility and diversity of role. Working in General Practice also offers better lifestyle options,” Di said. “There is a very different level and type of patient care and there is that chance to build a rapport with patients and develop relationships.”
Practice Nurses Di Leader, left, and Petra Hindley
“You have the ability to job share, there is continuity of care with patients and you know if you’re not at work tomorrow whatever you had to do the following day will get picked up the next day by the next nurse.” “There is also that huge sense of achievement because you’re not offering one time care to someone, the rewards come from sharing a patient’s progress.”
Marian McKenzie, left, and Robyn Barton New England Medicare Local | Page 7
Narrabri’s Tammy Shields works across two General Practices, the Narrabri Medical Centre and Namoi Medical Services. She became a Primary Health Care Nurse twoand-a-half years ago after being employed by Dr Ojah. Prior to that she worked for 20 years in Aged Care as an RN. Tammy said she thoroughly enjoys the Women’s Health aspect of Primary Health Care Nursing. “I hope, in the future, when I have the time I can further my studies in women’s health and in particular, women’s sexual health,” she said.
It’s a similar story for Primary Health Care Nurses Marian McKenzie and Robyn Barton, from Tamworth’s Smith Street Practice.
Tammy enjoys the variety of Primary Health Care Nursing and confesses she no longer cries when she gives babies their needles. “I did when I first started in the role,” she said.
Marian has been a Primary Health Care Nurse for five years. Prior to that she worked in hospitals and with the Aged Care Assessment Team. She said another benefit of working in Primary Health Care was the opportunities it afforded when it came to further training. “There are opportunities to specialise in areas where you have an interest,” said Marian, who is currently undertaking further studies in mental health. “You can, if you are interested, expand your skill set and there is time and support to do that.” Marian said she also enjoys the opportunity to partake in procedural triage. “If there is more than one nurse in the practice you can also play to each others strengths and share the workload,” she said. Robyn agrees. She said after juggling working in acute care and primary health care for a while to begin with, she thoroughly enjoys working solely in Primary Health Care. “I enjoy the teamwork and patient interaction,” she said.
Practice Nurse Tammy Shields, left, with Practice Manager Joanne Parks
For more information
on current Practice Nursing job vacancies in our region visit http://healthcareers.neml.org.au/
Contact Jodie Westhorpe
Primary Care Nursing Program Manager 02 6766 1394 jodie.westhorpe@neml.org.au
“There are other obvious benefits such as regular hours and free weekends, but the biggest reward comes from helping and working with chronic patients to improve their lifestyles and then seeing patients improvement and progress.”
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PR VIDER SUPP RT OFFICERS
Variety is the spice of life for our New England Medicare Local Provider Support Officers
Tanya, Armidale
Kelly, Glen Innes
Recently, a typical day for Tanya has involved helping a General Practice to become accredited.
Many of NEML’s Provider Support Officers are required to travel to offer support.
This includes ensuring resources are up to date, carrying out mock surveys and checking that the practice is displaying the signage required to meet accreditation standards. An immunisation cold chain audit is performed on the vaccine fridge and recommendations are then made to improve in some areas.
For Kelly, that involves a 50 minute drive to deliver immunisation and Nursing in General Practice resources.
Tanya also provides support on the use of Medical Objects to send referrals, resources on care planning and MBS item numbers. She has also been busy facilitating a presentation on the programs offered by NEML’s Aboriginal Health Team, such as Closing the Gap and Care Coordination and Supplementary Services for local Practice nurses to increase awareness of the programs and what they offer. UNE practice manager, Gay Leys is grateful for the support. “This is the first time that we have been accredited and all of the support Tanya has given us has been very helpful in getting us prepared for the surveyors. Her knowledge of what is needed and her can do approach are invaluable,” she said.
When she arrives, Kelly reminds the Practice’s Primary Health Care Nurses about their next practice network meeting. She also provides a quick refresher course on using Medical Objects computer software. She hits the road again, this time to deliver an education session for the Primary Health Care Nurses at the next Practice about General Practitioner Management Plans, Team Care Arrangements for patients, eligibilities for these plans, and the role of a Primary Health Care Nurse in developing and reviewing these plans, as well as Medicare Benefits Schedule item numbers and claiming periods. Various templates, Medicare Benefits Schedule reference sheets, links to further online learning and a Resource Manual are provided by Kelly to the Practice. The small education sessions always receive positive feedback: “excellent” and “a good basic overview for all staff”. Back at the office, Kelly updates her notes in the NEML computer database to reflect the day’s work. A phone call from a local Practice results in an unplanned Practice visit to help troubleshoot Medical Objects. Kelly returns to work but not for long, she is soon back on the road navigating around turtles and cattle to pick up and then drop off some local doctors on a 24 kilometre round trip to the airport.
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Julie, Moree Our Moree based Provider Support Officer has a 6am start, driving two hours to Gunnedah with our Narrabri based Provider Support Officer, Helen, for an eHealth Assisted Registration day at Gunnedah Rural health Centre and Primary Health Care Nurse meeting at the Gunnedah NEML office. 38 eHealth consumer registrations are completed at the Gunnedah Rural Health Centre during the morning. These registrations provide patients with a simple way to register for a Personally Controlled Electronic Health Record, as well as information on how the system can be of benefit to their health care. At lunch time Julie and Helen head to the Gunnedah NEML office on Barber St to attend the Primary Health Care Nurse meeting, with Jodie Westhorpe, New England Medicare Local’s Primary Health Care Nursing program manager. During the meeting a guest speaker from Community Health presents a session on wound care and the nurses discuss the future format of meetings and potential discussion topics. The meeting also provides the nurses an opportunity to network with peers and share information and knowledge.
with NEML Clinical Services and Aboriginal Health staff to organise joint visits to Practices to inform them of the services offered in NEML programs. Later that evening, Stephanie hosts a Primary Health Care Nurse meeting which includes speakers from the NEML Aboriginal Health team, a Nurse Practitioner from a local Practice. Guests from Hunter New England Health and the University of New England are also invited to discuss Aboriginal Health, Aboriginal health checks and strategies for engaging with the local Aboriginal community.
Helen, Narrabri It’s not uncommon for Narrabri-based Helen to traverse more than 450kms to provide Practice support to four rural centres. Helen began her day meeting a new General Practitioner and Practice staff and providing information on upcoming training being provided by NEML. During the visit Helen also provide information about the sign up process for the eHealth Practice Incentive Payment, and the assistance NEML is able to provide for this. During her second stop for the day Helen updates the NEML database with some Practice staff changes and provides the Practice with a Medicare Benefits Schedule Item Number resource document to assist with claiming. Due to the staff changes, Helen worked with the reception staff to complete some forms required to update their eHealth system details with the Department of Health. After an hour’s drive to the next Practice, Helen meets with NEML’s eHealth program manager, Marilyn, who provides the Practice with training on integrating eHealth into daily Practice activities. Marilyn has also created a template for the practice to use when referring patients to the Department of Veterans Affairs Coordinated Veterans Care program. Helen also updated the Practice with the latest referral forms for access to allied health services funded by NEML.
Stephanie, Tamworth Stephanie started her morning updating the NEML database with local health service information for use in the National Health Service Directory; a website which provides the public with information on health services available Australia wide.
After that Helen jumps in the car for another 30 minute drive before arriving at the next practice where she assists the Practice Manager with After Hours reporting. On the way home, using hands free, Helen phones in to another meeting.
A visit to a new local Practice takes up the afternoon. Here Stephanie assists staff to transfer patient files from another Practice that is no longer in operation. While there, Stephanie finds out the Practice has passed accreditation for the first time, and Practice staff are grateful for the help she provided throughout the accreditation process. When she returns to the NEML office, Stephanie liaises New England Medicare Local | Page
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New England Medicare Local Primary Health Care Nurse,
i d n i g n in Mu
Emma Graham, recently hosted a Bowel Cancer information night in the small town of Mungindi.
The idea for the evening developed after a member of the Progress Association called Emma just before Christmas. “There had been several well-known people in Mungindi diagnosed with bowel cancer in the previous few months and the community was wanting to know more about the disease,” said Emma. To pull the event together Emma worked in collaboration with the QLD Cancer Council and HNE Health Oncology Unit in Moree. People from Mungindi travel either to Toowoomba or Moree for cancer services and treatment. Four guest speakers were invited to the event: Claire Condon, QLD Cancer Council, who spoke about what bowel cancer is and the bowel screen program; Oncology Clinical Nurse Specialist / McGrath Breast Cancer Nurse Moree Chemotherapy Unit, Wendy Allen, who spoke about cancer treatment; and Jann Tuart, an Oncology Social Worker for Moree Community Health, who spoke about her outreach service to Mungindi. Amber Copland, QLD Cancer Council, spoke about how to support people in the community with cancer and the services the QLD Cancer Council provides in Toowoomba. Thirty-three people attended the evening which was held at the Mungindi Hall. The information evening was well received and the variety and quality of the speakers commended. “Participants said they had learned a lot from the evening,” Emma said. “The Mungindi progress association was a great help with event promotion, the hall hire, organising tea and coffee etc.” Our Primary Health Care Nurses work with small communities to target areas of need and health issues they feel are important. They do this through well being programs, information and education presentations, and evenings and health events in communities by working with the people who live there. To find out more about the New England Medicare Local Primary Health Care Nurse closest to you, please phone your nearest NEML office.
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New England Medicare Local Coordinated Continued Professional Development Update New England Medicare Local’s Continued Professional Development sessions for 2014 are already well and truly underway. The calendar for the coming months is filling up and there is sure to be something to pique everyone’s interest. One of the first CPD events held this year was ‘Trauma, Mental Health & General Practice’ presented by our very own visiting Psychiatrist Dr Tanveer Ahmed in Armidale. There were 17 registrations for the event, a mixture of GPs and Mental Health workers. The workshop covered recognising and diagnosing Post Traumatic Stress Disorder and the co-morbidities associated with this illness. Dr Ahmed, a popular and dynamic speaker, covered the relevant treatment and the role of the GP. Comments following the event included: “Good presentation – clearly presented in an orderly, simple and logical way.” “Great, really useful information and practical case discussion.” “Excellent, great to have a sequel to this.” If you’re not registered for our Weekly CPD News and would like to subscribe please email Katie.Moor@ neml.org.au or phone 02 6792 5514. Events are also regularly updated on the NEML website www.neml.org.au
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Nourishing Networks Eating Disorders update Workshop Dr Miriam Grotowski, Mrs Deanne Harris and Ms Fiona Little: 6.30pm 9.00PM Tamworth Education Centre, UoNDRH, Tamworth
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Palliative Care & Pain Management 6.30pm - 9.00PM Moree Venue TBA
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Lifestyle Risk Factors and Services Prof Garry Egger 6.15pm - 9.00pm Tamworth Education Centre UoNDRH, Tamworth
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Prescribing the right medicine for doctor retention Across the New England/Northwest region there are more than 40 doctors training to be GPs. Known as GP registrars, these doctors come from a range of backgrounds and have different levels of familiarity with the region. As these doctors are required to move around the region during their GP training, even a registrar who grew up in the area may need help settling into a new town. The local community can play a significant role in helping these professionals and their families settle into a new area, and their decision to remain practising in the region. To raise the profile amongst local community groups of the need to support new health professionals, the local General Practice training provider, GP Synergy, the New England Medicare Local, and local councils have joined together to host a series of community networking events for health professionals across the region. This includes Tamworth, Armidale, Moree and Inverell. Attendees at the events held to date have included GP registrars and other health professionals, as well as representatives from local hospitals and healthcare providers, local councils, schools, General Practices, the Rural Doctors Network, and other community service groups. Local MP, Kevin Anderson, attended the Tamworth Community Networking Event, and welcomed the new GPs and reinforced the importance of attracting and retaining health professionals in the region. According to GP Synergy CEO Mr John Oldfield, based on data collected over the last seven years, the retention rate of registrars staying on in the region after training was 51%. This included doctors who had previous ties with the region prior to training, as well as those that did not. “Making registrars and their families feel welcome and supported in rural communities will enhance the likelihood of them staying and settling in the region for the longer term,� Mr Oldfield says. This story has been supplied by GP Synergy, for more information about their events or GP training, contact info@gpsynergy.com.au or 02 6776 6225.
ABORIGINAL HEALTH
Snap Shot The NEML Story… Story re-told by Debra Adams Aboriginal Health Care Coordination RN / Diabetes Educator
Fuel Cards GM is a 42-year-old single parent of two who requires renal dialysis three times a week in Toowoomba. He is awaiting a kidney transplant. There is no reliable transport to Toowoomba Hospital. Since he lives in NSW the hospital is unable to provide any transport assistance. He faced having to move his kids out of their regular school and leave his family supports and move to Toowoomba. By providing the fuel vouchers, he can get family to drive him to the dialysis until he can be assessed for home dialysis or receive a transplant. We have a client who was recently diagnosed with bilateral breast cancer. She is a healthcare worker, but quickly realized that she was only two pays from being in serious financial difficulties. She felt shame for having to ask for help. We went to her Mum who was her driver and support person and let her ask for the fuel cards. We offered to provide them for chemo, doctors’ appointments, and cancer support meetings. Soon the client started coming in and felt comfortable talking about upcoming appointments. She bonded with a NEML health worker who had been through the same journey and they realized the similarities between their stories. It became easier and easier for the client to ask for assistance and now she stops by the office as soon as she gets an appointment even if it’s months away. It gives us an opportunity to listen and support her through her challenges. We have a client from Narrabri who has a rare form of cancer that affects his blood. He sees a specialist in Sydney. His wife drives to his appointments and takes her six children since they have no family in Narrabri. They missed several appointments, because they just could not afford the petrol for their van. The fuels cards have enabled them to travel together as a family at their own pace. They haven’t missed an appointment since. There are several clients who live in Narrabri who do not have access to MSOAP-ICD clinics. They are encouraged to attend allied health at the local hospital, but most are not happy to go there and prefer a more culturally appropriate environment. With the fuel cards we are able to bring them down to Gunnedah. Some are travelling down on a regular basis to see the podiatrist, diabetes educator, dietitian and exercise physiologist. The feedback we get is that they would rather travel and get the care they require and the fuel cards makes this possible. Through having the Exercise Physiologist Clinic, clients have the option to visit their office and work on their personalise exercise plan. With the fuel cards it is now possible for the clients to attend on a regular basis and feel that they can better manage their chronic disease. We see changes in these clients that are not only physical, but also emotional, while finally being able to access a program where they can see real results. Similar stories to these are too many to count. The positive results of availability of fuel cards can be measured by the number of patients that are able to get to the specialist appointments and the improvement that has made in their health care.
Healing the past, building the future The sixth anniversary of the National Apology to the Stolen Generation was celebrated with a special ceremony themed “Healing our past, Building our Future” in Tamworth on Thursday February 13. The ceremony, organised by New England Medicare Local in partnership with the University of Newcastle, included performances by Aboriginal dancers from Peel High School and a smoking ceremony by local Aboriginal Elders. The ceremony, which attracted more than 150 people, was designed to encourage further healing and acknowledge the long road travelled in the six years since the apology. An importance was placed on acknowledging that the apology and events preceding it happened, and now encouraging younger generations to preserve Aboriginal culture as they move into the future. A number of quotes were used throughout the day to reinforce the event’s focus. “It seems to me that if we can imagine the injustice then we can imagine its opposite. And we can have justice.” - Redfern Park Address, The Prime Minister Paul Keating “Racism is only achieved at the weakness of its opponent” – Unknown “ No one is born hating another person because of the colour of his skin, or his background, or his religion. People must learn to hate, they can be taught to love, for love comes more naturally to the human heart than its opposite” – Nelson Mandela “The practice of forgiveness is our most important contribution to the healing of the world” – Marianne Williamson “Although the world is full of suffering, it is also full of the overcoming of it.” – Helen Keller “We are all visitors to this time, this place. We are just passing through. Our purpose here is to observe, to learn, to grow, to love… and then we return home.” – Aboriginal Proverb. “He taught me the power of encouragement. He taught me the reward of having a go, where there seems to be no way up but if you persevere, if you don’t ever give up, then you can achieve things which others think impossible.” - Andrew Forrest, of Scotty Black, Aboriginal stockman and mentor
New England Medicare Local | Page 15
FROM THE DIETITIANS EVENTS DESK
For healthy tips, hints & ideas from our NEML Dietitians & much more. www.facebook.com/newenglandmedicarelocal www.twitter.com/NEMedicarelocal
What’s trending in nutrition? Freekeh Step aside quinoa… there’s a new (ancient) grain on the block. Freekeh is a high fibre, high protein and low GI grain produced by picking wheat grains before they mature. The high fibre content, at four times that of brown rice, is the standout nutrient when comparing freekeh to other grains. A large proportion of this is insoluble fibre, promoting good bowel health. The verdict: Freekeh is a great alternative to other common grains and can be included regularly, in place of rice, cous cous or other grains. Just remember that as you increase your fibre intake you also need to increase your water intake!
Clean eating Clean eating is a life-style eating plan where foods are eaten as close to their natural source as possible – think fresh (and often organic) fruit and vegetables, lean meats, fish, seeds, nuts (unsalted please!), raw honey and those more specialised ‘health foods’. Processed foods are seen as taboo in this plan - which is fine if we’re avoiding extra cake, chips or soft drinks – but clean eaters also often avoid foods such as pasta (which has a healthy low GI) and convenience foods like stir fry sauces or tortilla wrap kits (which on a busy day can be exactly what we need to make a healthy meal in a hurry!). The verdict: There are great health benefits to choosing whole foods and limiting processed foods, but not all processed foods need to be avoided. Grainy breads and cereals, rice, reduced fat cheese, and frozen vegetables are all examples of ‘processed’ foods that are a great source of nutrients.
Coconut The debate continues. Despite ‘health’ bloggers, the media and the marketing world raving about the questionable health benefits of this ‘wonder-food’ (it’s been claimed to cure everything from bloating and sugar cravings to HIV), scientific evidence still points in the direction of consuming less saturated fat – including coconut oil – for health. The many health claims linked to coconut oil are vastly anecdotal and unproven. The verdict: If you choose to eat coconut, eat it because you enjoy it, not because you expect a miracle. Choose a variety of healthy plant based oils, such as olive oil (remember when the Mediterranean diet was the craze?), avocado, rice bran oil and canola oil.
New England Medicare Local | Page 16
Tech-savvy food In our ‘just Google it’ culture, we have instant access to a huge range of food and nutrition information from websites, blogs, ‘vlogs’, YouTube, Facebook and other social media. We have apps for recipe searching, calorie counting, ethical purchasing, restaurant reviewing and even grocery shopping! But not all e-advice is sound. Anyone can post information online and make it sound credible, so be on the look-out for things like ‘quick fix’ promises, extreme diet plans or ‘experts’ trying to sell a particular product or book – these are often signs that something suspicious is going on. The verdict: Go for it – but be careful. Choose blogs, apps and websites that you find easy to understand, and that are helpful and encouraging. If in doubt, ask a dietitian.
Sweet potato Freekeh cakes
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Top apps of the month: Better Health Ch annel by the Vi ctorian Government – a so reliable health inf urce of up to date and ormation on a va rie topics from spec ific health conditio ty of healthy recipes. ns to ControlMyWeigh t and exercise log by CalorieKing – a food that keeps track of your progress as you he management goalsad towards your weight . AwesomeEats – to play, while lea fun games for kids rning about fruit vegetables. and ShopEthical – an to match your sh app that enables you opping choices to your values by displa ying ratings for different companies based on justice and animal environmental, social issues.
Serves 4
Ingredients ½ cup cracked freekeh 1 medium sweet potato 1 cup frozen peas 1/3 cup breadcrumbs 1 spring onion, finely chopped
GOOD FOOD
2 cloves garlic, crushed 1 egg 2 teaspoons cumin 100g reduced-fat hard feta, diced Handful chopped basil Oil spray Baby spinach, sweet chilli sauce and grilled salmon to serve
Method 1. Cook the freekeh according to packet directions until tender. Drain. 2. Meanwhile, chop the sweet potato into large chunks and steam/boil for 10 minutes, or until tender. Drain and mash well in a large bowl. 3. Add the freekeh, peas, breadcrumbs, spring onion, garlic, egg and cumin to the sweet potato and mix until well combined. Add the feta and basil and gently stir through. 4. Use the mixture to make 12 small patties. Heat a frying pan and spray with oil. Cook the patties, in batches, for 3-4 minutes on each side or until golden and heated through. Alternatively place the patties under a preheated grill, turning after 3-4 minutes or until heated through. 5. Serve the freekeh cakes with a portion of grilled salmon, a handful of baby spinach greens and sweet chilli sauce. Enjoy.
New England Medicare Local | Page 17
BOOK EVENTS REVIEW
By
JANET ROBILLIARD Title: Fermat’s Last Theorem Author: Simon Singh There have been occasions while reading or listening to odd snippets that I have heard Fermat’s Last Theorem mentioned, without having the vaguest idea of what it was all about. When I heard that Simon Singh had written a book called “The Simpsons and their Mathematical Secrets”, I decided he was the person who was going to explain this most notorious problem of number theory to me.
became easier to deal with – imagine multiplying CLV by DCI! Fermat did most of his mathematical deductions between about 1637 and his death in 1665 and became something of a celebrity – he announced with fanfare that 26 was unique – sandwiched between 25 (or 5²) and 27 (or 3³) and constructed a proof, or an elaborate argument, which proved that 26 is a unique number. He developed probability theory, something that I have to admit I have always struggled with but as I was never the slightest bit interested in gambling or risk assessment for insurance agencies, I decided it did not really matter. I found it even more difficult to deal with imaginary numbers called i = the square root of -1 and so on eg 2i and to me this is an esoteric and chimerical concept. More interesting perhaps was Fermat’s discovery of the amicable numbers, which are pairs of numbers such that each number is the sum of the divisors of the other number eg 220 and 284. I have visions of short sighted mathematicians hunched over their desks dipping their quills and calculating sum after sum in order to find another pair of these friendly numbers.
You may already know this, but Fermat’s premise is based on Pythagoras’ theorem that we all learnt off by heart whilst in primary school: In a right angled triangle, the square on the hypotenuse is equal to the sum of the squares on the other two sides. Pythagoras was a genius who realised that numbers exist independently from the tangible world. He gained his mathematical skills mainly from the Egyptians and Babylonians who used geometry to find the boudaries of their fields after the Nile had flooded each year. Pythagoras was riveted by perfect numbers, which are numbers whose divisors add up to that number itself eg 6: the divisors are 1,2 and 3 which add up to 6. He realised that numbers and their patterns are hidden in everything, from harmonies in music to the orbits of the planets. I was fascinated to learn of the ratio between the actual length of a river and its direct length as the crow flies – it is always about 3.14 or π…!
Fermat’s Last theorem, though, was a variation of the Pythagorean equation, x² + y² = z²: x³ + y³ = z³. He altered this equation, changing the cubed 3 to any number at all, (or n) and declared that these equations were impossible, that he could prove it and he urged others to do so. He scribbled in the margins of this hypothesis, in Latin, stating: “I have a truly marvellous demonstration of this proposition which this margin is too narrow to contain.” Mathematicians the world over have been trying to prove it ever since! For example Euler was an eighteenth century Swiss mathematician at the court of Catherine the Great, who developed a range of theorems and their proofs as well as the algorithmic method, but could not manage that particular proof. It became the most notorious problem in number theory until in 1995 after a couple of false starts, Andrew Wiles, at Cambridge University published a proof in the Annals of Mathematics. The proof itself took 8 years and over 100 pages. It won Andrew Wiles $50000 and the acclaim of mathematicians everywhere.
The book is really a history of mathematics, from Euclid and his thirteen volumes that make up the Elements, and Diophantus and his text on number theory to the Dark Ages, when mathematics in the west went into a decline and mathematicians in India and Arabia did what they could to advance the study of numbers – including changing the numerals to those we use today and adding zero – amazing to think that it did not exist before. Numeracy
Despite being a fairly dry topic, at least to the non mathematician, Simon Singh tells this story in an entertaining but obviously mathematical vein. Not only does he talk of calculus and probability, he tells us tales of obsession and perseverance spanning the centuries. He did seem to jump around from one era to the other, but generally the complete story describes the amazing properties of those things we take for granted in our day to day life: numbers! New England Medicare Local | Page
18
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