Health Times Feb 2017

H

February 2017

Midwifery special feature + Self-employed midwives have better emotional health + Canberra home birth trial delivers its first baby + Emergency nurse saves lives abroad + Fear of hypoglycaemia impacts diabetes management

SUBSCRIBE FOR FREE Visit HealthTimes.com.au/subscribe Or email contact@healthtimes.com.au

HealthTimes - February 2017 | Page 11

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1300 221 971 | smartnurses.com.au Page 02| www.HealthTimes.com.au

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Pulse is a leading provider of nursing staff across Australia. We have been recruiting for over 15 years and have long-standing relationships with various clients, so whether you’re looking for the next step in your career or a new challenge, our specialist nurse-led recruiters will support you.

We have a variety of fantastic permanent, temporary and contract roles available in metro and rural areas across Australia, for midwives and nurses specialising in: • Aged care • Theatres • General medical and surgical

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HealthTimes - February 2017 | Page 03

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February 2017 We hope you enjoy perusing the range of opportunities included in this Issue.

If you are interested in pursuing any of these opportunities, please contact the advertiser directly via the contact details provided. If you have any queries about our publication or would like to receive our publication, please email us at contact@healthtimes.com.au

Advertiser list AACDS Australian Medicines Handbook Australian Volunteers International Barwon Health CCM Recruitment International

DISTRIBUTION 46,300

Charles Sturt University

The HealthTimes magazine is the most widely distributed national nursing and allied health publication in Australia.

For all advertising and production enquiries please contact us by telephone on 1300 306 582, email contact@healthtimes.com.au or visit www.healthtimes.com.au Published by Seabreeze Communications Pty Ltd trading as HealthTimes.

ABN 29 071 328 053. Š 2017 Seabreeze Communications Pty Ltd. All right reserved. No part of this publication may be copied or reproduced by any means without the prior written permission of the publisher. Compliance with the Trade Practices Act 1974 of advertisements contained in this publication is the responsibility of those who submit the advertisement for publication.

CQ University Defence Force Recruiting Health Recruitment Specialists Medacs Healthcare Medibank NSW Health - Cooma Hospital Oceania University of Medicine Officeworks Pulse Staffing Quick and Easy Finance Royal Flying Doctor Service Smart Salary

Next Publication: Mental Health feature Publication Date:

Monday 20th March 2017

Colour Artwork Deadline: Monday 27th March 2017

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Stay up to date with the 2017 aMh Book or online AMH 2017 includes up-to-date drug information to help you stay informed in your profession. Every edition has hundreds of amendments, updates and additions to reflect the latest shifts in evidence and practice.

More than 20 new drugs have been added to the latest edition, including Ulipristal for emergency contraception, Idarucizumab for reversal of dabigatran anticoagulation and Paritaprevir with ritonavir, ombitasvir and dasabuvir for chronic hepatitis C. Therapeutic topics have been reviewed and updated, eg Dyslipidaemia now includes evolocumab and a table comparing lipid-lowering drugs.

There is also new safety information, eg severe skin reactions with bromhexine.

New to AMH online is a drug interactions search capability, for interactions between drug/drug or drug/class pairs.

To find out more, go to www.amh.net.au

optiMiSe Care to the elderly with the aMh aGed Care CoMpanion The AMH Aged Care Companion is a trusted, practical reference for doctors, nurses and pharmacists who work with older people. It contains the latest evidencebased information and is useful when conducting medication reviews and other activities (eg case conferencing) aimed at improving patient outcomes.

Latest edition changes include: • a new topic on actinic keratosis • information on the process of deprescribing important for optimising the use of medicines in older people • new illustrated inhaler device guide with links to instructions for choosing inhalers suitable for older patients Other topics reviewed include asthma, COPD, gout, hypertension, dyslipidaemia and dyspepsia.

Available in print or online.

HealthTimes - February 2017 | Page 05

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I was just getting ready to eat my lunch when I got the call. The good news was that my manager had safely arrived for the pharmacy expo. The bad news was, the promotional flyers hadn’t.

But I was all over it.

I called my Officeworks Business Specialist and gave him the lowdown. Luckily, I had the flyer artwork on file, so he helped me arrange a reprint at an interstate Officeworks store using the Print & Copy service.

All my boss had to do was pick them up on his way to the expo. He had plenty of time to set up our company stand and text me a photo of how good it looked.

I’ve never seen a bigger grin on his face.

Get all over it.

Visit officeworks.com.au/business-solutions

Printed for 30/01/2016.

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OWO2357

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HealthTimes - February 2017 | Page 07

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My London Nursing Experience an adventure I encourage for all nurses

What is your favourite aspect of living and working in London?

Being part of an expat community, I have met people from all over the globe, giving me even more reasons to travel! Having a great social network to keep me busy on days off – museums, pubs, concerts, art galleries, and day trips to the countryside or further afield into Europe. I’m loving f building memories from all my adventures which I would never have How has working in London achieved if I hadn't moved to this side of affected your clinical experience? the world.

Relocaang to London has proven perfect to increasing my clinical What have you found the most exposure to a new variety of challenging aspect of living and working paaent populaaons, condiaons in London? and nursing standards. The It took me some ame to seele in and hospital I work at has great become accustomed to a new hospital faciliaes and an advanced system. When I first started working, I app approach to diagnosacs and found all the policies so different and treatment compared to back wished I could just do things the way I home. I take advantage of every knew how. I found remembering why I opportunity to further my skills moved, helped overcome this challenge, and expand my professional scope. changing my perspecave to take every opportunity as a learning curve and Describe your lifestyle in London. focusing on the posiaves.

London offers something for everybody and I’m trying to make Would you encourage others to make the most of every opportunity. I’m the move to London? heavily involved in some great Yes! I would highly recommend it! The social sports clubs with lots of NMC registraaon process can seem other Aussies and Kiwis to keep daunang, but it is worth the effort. You acave. It was a great way to meet can gain great clinical and professional first arrived and we skills as well as exploring the world. people when I fi have stayed great friends. The Seeking guidance with your nursing causal ‘pub lifestyle’ has rubbed registraaon would be my best ap. It is a p and I appreciated having off on me, I tend to go out more long process than I would back home. I also somebody checking in on me along the love exploring the local food and way. Being able to pick up the phone and craa markets. gain assistance really helped and made the process smoother.

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HealthTimes - February 2017 | Page 09

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Apply now at csuonline.edu.au or call 1800 334 733 Page 10| www.HealthTimes.com.au

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HealthTimes - February 2017 | Page 11

Call for psychology student trainees in aged care

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sychology postgraduate student trainees could improve the mental health and functioning of older people living in residential aged care facilities while reducing the use of pharmacological treatments, under a proposal from the Australian Psychological Society (APS).

In its 2017-2018 pre-budget submission, the APS has called for the Federal Government’s support to launch a 12-month trial for psychology students, who are training in courses such as clinical psychology, health psychology and clinical neuropsychology, to provide psychological assessments, as well as mood and behaviour management interventions for residents, under supervision.

The initiative, designed to improve access to psychology services in aged care, also includes training for aged care staff in behaviour management.

The proposal comes amid revelations that government-funded residents of aged care facilities are being denied access to vital Medicare-funded psychological treatment under the Better Access Scheme.

Studies show the incidence of psychological disorders such as depression and anxiety is higher among people living in aged face facilities compared to those living in the community.

In its submission, the APS states mental illness and disruptive behaviour among aged care residents is often treated with psychoactive

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medication ‘which has undesirable side effects and is expensive to provide and monitor’.

‘Psychological assessment and intervention for older Australians have been shown to be effective in managing mood disorders and disruptive behaviour, and to improve quality of life for residents as well as reducing costs for the facility by decreasing the need for pharmacological interventions’, it states.

‘However, there is currently extremely limited access to psychological assessment and treatment for people living in aged care facilities.’

APS executive director Professor Lyn Littlefield OAM said evidence shows several psychological treatments are effective for treating anxiety and depression in older people but pharmacological treatments are most often being used to treat mental illness.

“This is most likely because it is very difficult for doctors to access psychological care for residents. Yet the use of such medication quite often produces unpleasant and unnecessary side effects,” she said.

“There is also the erroneous beliefs that depression and anxiety in aged-care can be considered ‘normal’ and that frail older adults with dementia or other chronic disease are not suitable for psychological treatment.

For the full article visit HealthTimes.com.au

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Director of Clinical Services Our client, Maryborough District Health Service is seeking a candidate with energy, innovation and drive to seek and deliver clinical services for this exciting and challenging role. The position might be an opportunity for you to take that next step in your career and utilise your combined clinical and corporate knowledge at MDHS. Reporting to the Chief Executive Officer you will be a proactive member of the executive leadership team at MDHS with responsibility for the professional and business leadership and management of MDHS clinical services.

To meet the requirements of the role you will have current unconditional AHPRA registration as a Registered Nurse and hold post-graduate qualifications in management. MDHS is seeking someone with advanced knowledge of funding and accreditation requirements and demonstrable success in the management of clinical service delivery.

For full details of the roles see our website at www.hrsa.com.au or contact Jo Lowday on: 0400 158 155.

Applications close Wed 15 March 2017 PO Box 83 Ocean Grove 3226 hrsa@hrsa.com.au www.hrsa.com.au

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Where will 2017 take you?

DEVELOP YOUR CAREER. EXPERIENCE A NEW CULTURE. The Australian Volunteers for International Development (AVID) program enables Australians to share their skills overseas through fully-supported volunteer opportunities in 22 countries.

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HealthTimes - February 2017 | Page 13

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If you own a car that is registered in your name (or your partner’s) you can borrow* up to $20,000 against its value.

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Remote Area Nurse - Andamooka, SA Full Time Opportunity • Salary Packaging Benefits Join a great Australian icon. Working with the Royal Flying Doctor Service (RFDS) you will be joining a team of dedicated professionals providing health care to people living and working in regional, rural and remote Australia.

RFDS Central Operations operates primary health care clinics in Andamooka, Marla and Marree. We are seeking an experienced and enthusiastic Remote Area Nurse (RAN) to join our primary health care team in Andamooka. The RAN will be a part of a multidisciplinary team providing primary health care and emergency services to the community and visitors. RFDS Central Operations operates a two nurse staffing model.

This is a unique and exciting career opportunity and workplace offering attractive remuneration and benefits including salary packaging and relocation allowance.

If you are keen to move your career into an organisation that makes a real difference to all Australians, apply now.

For further details and the position description, please visit our website at www.flyingdoctor.org.au The Royal Flying Doctor Service is an Equal Opportunity Employer

HealthTimes - February 2017 | Page 15

Canberra home birth trial delivers its first baby

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ittle Ari Cvjeticanin is the first baby to be born through Canberra’s publicly-funded home birth trial.

The baby boy, weighing in at four kilograms, was born in parents Ella Kurz and Relja Cvjeticanin’s home on January 21, with the assistance of two midwives from the Canberra Midwifery Program at the Centenary Hospital for Women and Children.

Professor of Midwifery Deborah Davis, who holds a joint appointment with the University of Canberra and ACT Health, said Ari arrived safely, without complications.

“We were all thrilled to bits - he’s a big bonnie boy which is great,” she said.

“The couple were delighted and I think the midwives were really happy with how everything went. It was very successful.”

The ACT Health threeyear home birth trial, which opened in October 2016 for applications, will provide one to two home births a month, or up to 24 a year, for lowrisk pregnant women who live within a 30 minute radius of Centenary Hospital.

Under the model, two midwives will be present at each birth and work closely with a team of midwives, obstetricians and neonatologists.

“The service is an extension from our existing continuity program and they have been supporting women to give birth in the birth centre for a long time, so it’s the same model of care but the place of birth is different,” Professor Davis said.

“The midwives, as usual, are on-call for the women, and when a woman rings up in labour,

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the midwife goes to her home when she needs the midwife’s attention.

“We have a second midwife who comes in when the labour is well established, well towards the end, so that there are two qualified midwives at the birth.

“Our process is that they leave some equipment at the home in advance of the birth in those last weeks, so everything is there and ready to go.

“We have really good established processes of communicating with the service back at the hospital, so that they know what is happening, and they know when the midwives are there and they know when the midwives have left.”

Professor Davis said the home birth service gives Canberra women another choice.

She said the program has received positive support from the community, and about 10 women are now booked in to birth in the comfort and privacy of their own homes.

Midwives have also welcomed the trial, with about 10 midwives from the program’s existing pool of continuity of care midwives coming on board for the initiative.

“We had an expression of interest process before the program started, and we did a lot of work with the midwives to ensure that they had everything they needed to be able to provide care in this sort of environment in terms of education and skills and experience,” Professor Davis said.

For the full article visit HealthTimes.com.au

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Looking for a tree change?

We are seeking expressions of interest from qualified, registered midwives looking for permanent and/or temporary work in a rural Maternity Unit, situated in the town of Cooma, Southern NSW. Cooma Maternity Unit is part of the Cooma District Hospital and is a Level 3 Maternity Unit caring for low risk women. The hospital has the capacity to support normal birth for women when birthing occurs from 36 weeks gestation onwards and offers antenatal, intra partum and post-natal care.

Cooma is surrounded by national parks and is an hour from the south coast beaches, Canberra, NSW Ski Fields and the Snowy Mountains. The position(s) offer great lifestyle opportunities for you and your family, with good schools and many sporting activities in the Cooma area.

The model of care is GP Obstetrician led with fulltime midwifery input. The unit is staffed by a single midwife per shift, requiring the applicant to work autonomously whilst liasing with the GP Obstetrician.

Approximately 150 babies are delivered per year. Our nursery is classified as a Level 2, with higher acuity neonatal care offered by the tertiary referral centre one hour away.

We offer genuine woman centred care with a focus on family support. Our unit’s postnatal beds can accomodate partner overnight stay, which is in line with our family friendly model of care. We are currently working towards baby friendly accreditation.

All staff employed within Cooma District Hospital qualify for addtional salary packaging benefits.

If you are a registered midwife and are interested in working in a rural setting, with a great team, please contact Cooma Hospital.

Email: SNSWLHD-CoomaHospital@health.nsw.gov.au Ph: (02) 6455 3230 Mob: 0417 674 046

HealthTimes - February 2017 | Page 17

Self-employed midwives have better emotional health

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elf-employed continuity of care midwives work more hours but have lower levels of burnout, anxiety, stress and depression than midwives working in New Zealand’s hospitals, new research shows.

A New Zealand College of Midwives’ study of more than 1000 of its members, representing a third of the nation’s midwifery workforce, has found despite being on-call and working longer hours, midwives providing continuity of care in a caseload model have better emotional health than their hospital colleagues.

Employed midwives working in maternity units in hospitals, experiencing rotating shift work, fewer work hours, and staff shortages, have higher levels of burnout and anxiety, the study reveals.

Lead author Dr Lesley Dixon (PhD), a registered midwife and midwifery advisor at the New Zealand College of Midwives, says the research, published in the New Zealand College of Midwives Journal, demonstrates self-employed continuity of care midwifery is a sustainable profession.

“Midwives who work as Lead Maternity Carers are actually on call 24/7 so they work to provide care from early pregnancy, through labour and birth and into the postpartum period,” she says.

“That obviously means they are on call for women who go into labour and get called out at odd times, night times and weekends, so there’s a potential there for long hours and being on-call a lot can be quite problematic.

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“We were getting concerns raised about whether this was actually causing problems to the emotional wellbeing of midwives - was this causing problems to their health, was it increasing the levels of burnout for those midwives?”

But Dr Dixon says the research instead shows self-employed midwives experience greater professional autonomy and flexibility, supportive midwifery partners, and feel more empowered - which works to protect their emotional wellbeing.

“Working in continuity of care does not increase burnout or make midwives more vulnerable in their emotional wellbeing, and really what we’re thinking is it’s actually the working with women that supports sustainability, it’s having autonomy over your work hours and your client load, it’s having that control which actually supports the midwives’ emotional wellbeing.

“Self-employed midwives get a lot of satisfaction from working with women through the continuum from early pregnancy through to postnatal, and it seems that being able to do that and working with the women is actually quite protective.

“So despite working the longer hours, the type of work that they’re doing seems to be more protective of their emotional health essentially because they are getting more job satisfaction.”

New Zealand introduced its internationallyrenowned autonomous midwife-led model of maternity care in 1990.

Under the system, Lead Maternity Carer (LMC) midwives care for 90 per cent of the country’s pregnant women throughout their pregnancy, labour and postnatal period.

New Zealand women have a choice of where they give birth, and the LMC midwife works with women and provides care in the woman’s choice of birth place.

In 2014, there were 57,242 live births registered in the nation. Statistics from 2012 show 3.1 per cent of women choose to give birth at home and 9.7 per cent give birth in a birthing unit. Meanwhile, 40.9 per cent gave birth in a secondary hospital and 46.3 per cent in a tertiary hospital.

The New Zealand College of Midwives’ study, a project which included researchers from the University of Melbourne, Griffith University, Gold Coast University Hospital and Auckland University of Technology, surveyed members in 2013, with respondents including midwives who worked in hospitals, selfemployed caseload midwives, and midwives who worked in both settings.

Dr Dixon says the study found employed midwives are “a lot worse off” - working fewer hours but experiencing more burn-out than self-employed midwives.

“What we’re seeing is that the midwives who are employed have less autonomy over their work hours, over what they’re doing within their work, there’s less resources, and obviously there’s issues around staffing as well. We think that’s actually having quite a strong impact,” she says.

“Levels of autonomy, empowerment and professional recognition, and lack of management support are all having an impact on the employed midwives.

“The work of midwives needs to be valued more within the hospitals, by the hospital

managers and the leaders, but also within the Ministry and within the government as well,” Dr Dixon adds. “It is about gender and gender discrimination in the sense of women are becoming mothers and are not necessarily hugely valued - and women’s work is not always hugely valued either.

“Working with women and midwifery care is what sustains midwives, it’s the environments and the requirements within the institutions that actually cause problems for midwives.”

Dr Dixon says while the research examines the emotional wellbeing of midwives based on their type of work, researchers plan to compare the results with those of midwives in Australia and in Sweden, who have completed the same survey.

Researchers will also review the extensive range of comments provided by New Zealand midwives in response to the survey.

While midwives can use a range of self-report tools, such as the Depression, Anxiety and Stress Scale (DASS-21) and the Copenhagen Burnout Inventory (CBI) questionnaires, to assess their risk of burnout, Dr Dixon says there are some common warning signs.

“When you’re dreading going to work, not enjoying your work any more, becoming worried or anxious when you’re at work for things that would not have caused you anxiety before, those are some of the signs and symptoms,” she says.

“It’s really important to recognise burnout and to start looking at what you can do within your work environment to actually reduce the risk of burnout.

“It’s about recognising it and actually saying - this is an issue, and how do I change my work so that I can actually still continue to enjoy it and looking at what other opportunities are there for midwives?”

For more articles visit HealthTimes.com.au HealthTimes - February 2017 | Page 19

Physiotherapy clinics tap into online booking

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ore physiotherapists and other health professionals are now just a click or a swipe away thanks to the rise in online booking services.

Physiotherapy now has the third highest number of directory listings, after GPs and dental practitioners, on Australia’s largest online health directory and booking service, HealthEngine.

A million people each month access the online directory which connects patients with more than 70,000 listed health practitioners, including physiotherapists, nurses, nurse practitioners, midwives, audiologists, psychologists, speech pathologists, occupational t h e r a p i s t s , chiropractors and Chinese medicine practitioners.

The platform, which includes a website and a free app, also facilitates 500,000 bookings a month with more than 3500 clinics, or about 15,000 health practitioners, across the nation.

GP and HealthEngine CEO Dr Marcus Tan said physiotherapy has grown to become the site’s third key area.

“A lot of physios see the value in attracting new patients, so I think the value in our services have primarily been around offering up tools and information for patients as a key group to be able to empower them to manage their health care,” he said.

“But on the flip side, we obviously deal with the provider side, and giving them the tools to be able to engage with patients well, being

Page 20| www.HealthTimes.com.au

able to manage their private practices where they can ensure that they are full and not sitting around twiddling their thumbs.

“Also offering them tools that are more in the digital age to make things more efficient as far as their practices - things like the online booking system, so they don’t have to have too many staff at the front desk or on the phone, and being able to offer them things like recall systems to help them remind patients to come back.”

While the health care sector has traditionally been slow to embrace online solutions, patient demand is driving the move towards a significant growth in online directory and booking services - offering a more convenient way for patients to be able to book and manage their health appointments.

Health practitioners are also using the platform to track down other health professionals for their patients, Dr Tan said.

“Nurses are a first port of call…they are valued advisors to patients, and patients will want to know - who should I see for this or for that?

“We have a tool that allows patients or even the nurses themselves to be able to reference what else is going on in the industry, who else is out there and what they’re doing.”

For the full article visit HealthTimes.com.au

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HealthTimes - February 2017 | Page 21

Emergency nurse saves lives abroad

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elbourne emergency nurse Jean-Philippe Miller may have left the developing country of Myanmar but there’s little doubt his work continues to have an impact, saving lives in the country plagued by civil war.

The Alfred Hospital nurse has spoken about his missions with the International Committee of the Red Cross (ICRC), on secondment from the Australian Red Cross, where he worked as a firstaid trainer in Myanmar in 2015 and 2016 - sharing his life-saving skills and knowledge in a bid to help save lives in local communities.

Jean-Philippe also provided nursing care to people with gun shot injuries and with infectious diseases, such as malaria, typhoid and cholera, in South Sudan in 2014, while also assisting displaced people in need of general medical care.

“It was a very humbling experience and very eye-opening for me - you see a lot of cases that you don’t get exposure to in Melbourne, working in a tertiary hospital, because they’re illnesses that we just don’t come across.”

Jean-Philippe said it was his time working in Myanmar, one of the poorest countries in Asia, that was most rewarding, where he helped establish a train-the-trainer first-aid program to combat the lack of local ambulance services.

“Most lives lost in trauma as far as car accidents and things like that, they are very manageable from simple innovations,” he said.

“Someone might lose their airway, so if you can teach someone how to open an airway and transport someone to hospital, you can save their life.

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“Someone might die before they get to hospital because they lose blood, so if you can teach them the first-aid of how to control and stop bleeding, you can save their life until they get to hospital.

“These very basic things are generally what makes the big difference in survival rates before people arrive to hospital, and they are things that lay personnel can do - you don’t need advanced paramedics to make that initial large difference.”

Jean-Philippe said the ICRC team trained nurses, teachers and village health care workers to be first-aid trainers.

Those trainers are now able to train others in their local communities to provide basic first-aid care.

Jean-Philippe said the team also encouraged their trainees to use local materials when providing first-aid.

“We wanted them to realise that you don’t need to have a special qualification to provide first-aid and that you don’t need a first-aid kit to provide firstaid because you can use a piece of cloth, you can use your shirt, if you need to, to stop bleeding, you can open an airway - you don’t require any special equipment for that.

“It was very much encouraging lateral thinking - encouraging initiative and trying to let people know that there’s multiple ways of doing things.”

Now studying a Masters of Public Health, Jean-Philippe aims to complete more missions for the Red Cross in the future.

For the full article visit HealthTimes.com.au

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Fear of hypoglycaemia impacts diabetes management

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ne in seven people with diabetes is living with the fear of hypoglycaemia, which has the potential to impact their emotional wellbeing and management of the serious, complex condition.

With mental health care for people with diabetes recognised as a priority area in the Australian National Diabetes Strategy 20162020, the National Diabetes Services Scheme (NDSS) recently released a resource to help equip health practitioners, including diabetes educators, nurses, GPs, dietitians and other allied health practitioners, with the strategies and tools to better recognise emotional problems in the 1.7 million Australians living with diabetes.

The Diabetes and Emotional Health handbook and tool kit, a free online resource and the first of its kind in Australia, aims to assist health practitioners to reduce the psychological burden of the condition - in both patients and in their carers.

Dr Christel Hendrieckx, a clinical psychologist with the Australian Centre for Behavioural Research in Diabetes (ACBRD), which developed the resource in conjunction with Diabetes Australia, says health practitioners must talk to patients with diabetes about their hypoglycaemia at every consultation.

Dr Hendrieckx says practitioners should ask patients about their experiences of hypoglycaemia, including frequency and severity, how they manage it, and discuss the patient’s

Page 24| www.HealthTimes.com.au

knowledge and feelings about their low blood glucose levels.

“Hypoglycaemia is a well known complication of living with diabetes and more specifically it’s a side effect of the way we are treating diabetes today - it’s a side effect of injecting insulin and some of the medications people are taking,” she says.

“Health professionals know that it’s really a very impacting side effect of living with the condition but the emotional aspect, I think, is less known.”

Dr Hendrieckx says how hypoglycaemia impacts on patients’ lives does not often form a part of their conversation with their health practitioners.

“It’s a delicate conversation to have because it can have an impact on people’s driving or work conditions so it has to be in a very empathetic and nonjudgemental way - do you have hypos and do you have symptoms, do you recognise when your blood glucose is going low?

“You need to see whether the person has the understanding or the ability to pick up a hypo in time and to treat it, because if that’s not the case, I think health professionals should talk to the person about - how can we manage your hypos better, so you can avoid very low blood glucose levels.”

Dr Hendrieckx says people with diabetes who fear hypoglycaemia may change the way they manage the condition, impacting on their diabetes and overall health outcomes.

“If someone really is afraid of having a low blood glucose level, they might change the dose of insulin they are talking or they might snack more regularly than they should, just to avoid going low,” she says.

“As a health professional, if you are not aware of these changes that a person is making in their management, it’s harder for you to understand what is going on - why this person is getting these diabetes outcomes?

“We also know, for example, many people with diabetes fear the chronic complications the impact it can have on their vision or their kidneys, and that’s a very common concern for many people with diabetes.

“If you can talk about these fears you can get a better understanding about how the person is managing their diabetes in their daily life, and it will give you so much valid information on how you can support these people in a more holistic way - not just focusing on the medication or the diet or whether the person is exercising or not.

“The medical part of managing the condition cannot be separated from how people cope, think and live with the condition - it impacts on a lot of aspects of a person’s life.”

The resource comes as a new report, Incidence of Insulin-treated diabetes in Australia, from the Australian Institute of Health and Welfare (AIHW) shows 28,775 Australians 63 per cent with type 2 diabetes, 26 per cent with gestational diabetes, and nine per cent with type one diabetes - began using insulin to treat their diabetes in 2015.

The report, which uses data from the National (insulin-treated) Diabetes Register, shows 2617 people were diagnosed with type 1 diabetes in 2015 (around one in every 8000 people), the incidence was higher in males

than females, while almost two in three of people with type 1 diabetes were under the age of 25.

It reveals 18,142 people began using insulin to manage their type 2 diabetes (about one in every 1400 people), the incidence was almost 1.5 times higher in males than females, and more than 90 per cent of new cases of insulintreated type 2 diabetes occurred in those aged 40 and over.

The highest rates of insulin-treated gestational diabetes were among pregnant women aged 40-44, with almost one in three women, or 30 per cent, requiring insulin treatment.

Dr Hendrieckx says while many practitioners believe they don’t have the time to discuss emotional wellbeing, it can be easily and quickly incorporated into every consultation.

“It’s all intertwined. If you look at somebody’s blood glucose levels, and you talk about the blood glucose levels, it’s so helpful to understand what do these outcomes mean for this person - are they frustrated or happy about it, do they understand why they are getting these numbers, are they looking for a job and they are stressed about this specific situation?

“That gives you as a health professional a much healthier material to work with and to really support that person in that wholistic approach.

“Then you can work together with that person and say - I understand this, or the challenges with you living with your condition.

Let’s talk about how we can make it a bit more easier for you, what are the things we can discuss and agree upon which will become a bit more easier for you to live and manage your condition.

“Give it a try and see how it impacts on the relationship with your patients.”

HealthTimes - February 2017 | Page 25

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Men’s Health – A new frontier in physiotherapy “Lift your nuts to your guts.” usculoskeletal physiotherapist Jo Milios regularly uses this frank yet effective sentence when teaching her male clients about how to perform pelvic floor muscle training.

“Academically speaking, I should be asking them to shorten their penis because that’s the description that research came up with as being the best descriptor, but I learnt men don’t like to think of their penis as getting smaller,” she says.

“With ‘nuts to guts’, they kind of pause for a second, have a chuckle and then do it. Whereas, if I say ‘shorten your penis’ - they look at me with alarm, like they don’t want to go there.

“The language that you use really needs to be quite down to earth, and men tend to appreciate less medicalisation of everything.”

Jo’s approach may sound funny but the reality is men’s health is no laughing matter. While there’s been a rise in awareness, early detection and focus on treating women’s health in the past few decades, men’s health has largely been left by the wayside.

Jo, just one of a handful of practitioners specialising in men’s health physiotherapy in Australia, says men’s health is about 20 years behind women’s health.

The Perth physiotherapist, who runs Complete Physiotherapy and Men’s Health with her husband Dean, also a physiotherapist, says the statistics show one in seven men are diagnosed with prostate cancer in Australia while one in nine women are diagnosed with breast cancer.

On average, Australian men die 4.3 years earlier than women, while figures reveal almost 60 per cent of men are overweight or obese and almost 50 per cent of men don’t exercise regularly.

But, if prostate cancer is caught early, 94 per cent of men can expect to live to five years and 92 per cent to 10 years.

M

Page 28| www.HealthTimes.com.au

“We’ve got a rising occurrence of prostate cancer detection and excellent treatment options, so that we can usually cure a person of their cancer, but there are side effects with treatment,” Jo says.

“Undergoing a radical prostatectomy may impact on the quality of life for men - as they usually, instantaneously, have urinary incontinence and erectile dysfunction, and none of them really want to deal with that.

“So you’ve got about 22,000 cases being diagnosed a year in Australia and over one million around the world, so there’s a lot of it occurring and a lot of work to be done in catching up, providing them with the resources they need to get through the treatment.”

A physiotherapist of 23 years, Jo found herself gravitating towards men’s health after working with her brother, urologist Dr David Sofield, and realising there was a gaping hole in physiotherapy services for men battling prostate cancer.

Soon inundated with male clients, Jo linked up with the Prostate Cancer Foundation of Australia, established a not-for-profit community exercise program, PROST! Exercise 4 Prostate Cancer Inc, has run men’s health workshops overseas and in Australia, and is now undertaking a PhD at the University of Western Australia’s School of Sport Science, Exercise and Health.

Since specialising in men’s health, Jo has treated more than 2000 prostatectomy patients, 500 chronic pelvic pain patients, and hundreds of men with erectile dysfunction.

“It astounded me. I just kept seeing man after man after man sitting in front of me, really quite shaken up, with no understanding of where to go to get help,” she says.

“I very quickly had a couple of thousand patients under my belt because no-one else was really specialising in this area of physiotherapy.

“It’s all been a huge learning curve for me as well - I didn’t anticipate that my career would divert to this but I just saw an urgent need.”

Jo, a member of the Australian Physiotherapy Association’s newly named Women’s, Men’s and Pelvic Health Group (formerly known as the Continence and Women’s Health Group) in recognition of the emerging men’s health field of physiotherapy, says it’s vital physiotherapists play a greater role in embracing men’s health.

“There’s a lot of other professions that can’t really deal with it so well and we are the experts of muscle and exercise training but we just haven’t done very well with focusing on the male needs in the past,” she says.

“What I really want to do is try and get more physiotherapists, especially male physiotherapists, to think about opening their minds to making each opportunity with a male patient an opportunity to address men’s health in general,” she says.

“We need to do something about shortening that life span gap and getting men a bit more comfortable about being proactive about preventative health.”

Jo says physiotherapists should ask male patients, particularly from the age of 40 and over, about their bladder, bowel or sexual function, as well as their heart function.

“You can ask - do you have any concerns with your physical performance? It might be that they have started to notice that they’re getting a bit breathless with exercise and that can be an indicator that they’ve got some cardiovascular problems,” she says.

“Then you can ask deeper questions, especially if they present with low back problems, like - have

you noticed your erectile function or your morning erections aren’t quite happening as they were?

That’s important, because there’s a really strong link between heart health and erectile function health.

“Quite often if a man has narrowing in his heart arteries he will have reduced erectile blood flow there’s about a three year gap between when he’s noticed his erections haven’t been working so well and him having the onset of a cardiac event.”

Jo also wants every physiotherapist who treats male patients to learn how to instruct men in performing exercises to properly train their pelvic floor.

“The pelvic floor can be too tight, which can cause pain, or too weak, which can cause incontinence, so sometimes strengthening the pelvic floor can flare a patient, whereas relaxing the pelvic floor may be the best option,” she says.

“It would be great if every physiotherapist had the understanding that the pelvic floor is an important part of a male body - men should know where it is, what it feels like, and what’s normal.”

Jo, who will speak on men’s health at a symposium as part of the World Confederation for Physical Therapy Congress being held in South Africa in July, says men’s health is an incredibly rewarding field to work in.

It’s also an area, where there’s no room for embarrassment.

“Men are usually quite appreciative of you giving them the tools to fix themselves. Men just want direction, they are very easy to work with, and usually like a sense of humour thrown in to help them along the way,” Jo says.

For more articles visit HealthTimes.com.au HealthTimes - February 2017 | Page 29

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