medicinalchemistry » Pharmacy

Networks vs districts

Kieren — Sat, 21 May 2011 09:06:26 +0000

After only five-and-a-half months, our Local Health Networks (LHNs) in New South Wales are being rebranded again*. It seems that the new NSW government has decided to make its mark on the health service by fiddling with semantics. The Health Services Amendment (Local Health Districts and Boards) Act 2011 was proclaimed on 16 May and appears primarily to rebrand LHNs as “Local Health Districts” and LHN Governing Councils as “Local Health District Boards”.

Presumably the new terminology is intended to further evoke localism and the memory of hospitals being governed by local hospital boards. The legislation does not, however, appear to introduce any material changes to the structure/function of the health service. Hm… Well I guess we’ll be getting another new set of stationery…

* The original Area Health Services were amalgamated (and renamed) on 1 January 2006. Under the National Health and Hospitals Network agreement, the Area Health Services were demerged (mostly to the pre-2006 boundaries) and renamed Local Health Networks on 1 January 2011.

A tale of four tutors

Kieren — Sat, 31 May 2008 11:30:47 +0000

Four tutors at two Group of Eight universities in Sydney in the past two weeks: an allegory on some of the qualities of good teachers…

Tutor A teaches medicine. Although qualified in a clinical health science, she had little understanding of the subject material nor demonstrated any convincing attempt to do so. She did not attempt to establish rapport with the students in her class.

Tutor B teaches clinical sciences. Whilst clearly qualified in the majority of the subject material taught, he then attempted to teach some material which he didn’t understand (in a field where some of the graduate students in the class were qualified). He did, however, attempt to establish rapport with the students in his class with some success.

Tutors C & D teach in the Faculty of Pharmacy at USyd and the Faculty of Medicine at UNSW respectively. Although both are relatively young, they proactively ensure that they each have a thorough knowledge and understanding of the material taught. Appreciating the importance of connecting with students, they both make a high priority of establishing good rapport with the students in their respective classes.

Who would you prefer as your tutor?

Dysphasie en français

Kieren — Mon, 24 Mar 2008 08:15:46 +0000

The hospital I work at has an arrangement with the New Caledonian private health fund Caisse de Compensation des Prestations Familiales des Accident du Travail et de Prévoyance Familiales des Travailleurs de la Nouvelle-Caledonie et Dépendances (CAFAT), which means that we regularly have French-speaking patients under our care – many of whom have little command of English.

Recently, I needed to check whether one of our CAFAT patients had any more of her own supply of gabapentin. Having established that she didn’t understand any English, I was forced to deploy my very rudimentary French…

Me: Bonjour madame, je suis le pharmacien… Avez-vous plus de la gabapentine?
Pt: Looks at me blankly. Pharmacien?
Me: Oui. Avez-vous plus de la gabapentine?
Pt: Matin et soir… « unintelligible »
I try a different tack and show her the tablets remaining in her medication drawer.
Me: Voici deux comprimés de la gabapentine. Avez-vous plus?
Pt: Un le matin… « unintelligible »
Me: Oui, mais avez-vous plus de comprimés? Plus?
Pt: « unintelligible »
At this point I give up…
Me: Ok, merci.

I later noted that the reason for admission was a central nervous system (CNS) lesion. At this point I realised that she probably had dysphasia secondary to the CNS lesion… so perhaps it wasn’t (just) my bad French!

NAPSA Congress Sydney 2008

Kieren — Wed, 30 Jan 2008 11:41:36 +0000

I was asked to take the official photo for the National Australian Pharmacy Students’ Association (NAPSA) Congress 2008, this year hosted by the Sydney University Pharmacy Association (SUPA) – both organisations with which I have had a fair bit of involvement over the years.

NAPSA Congress Sydney 2008 official congress photo
(click on image for full-size version)

To achieve this image, I borrowed a Canon EF-S 10–22mm f/3.5–4.5 USM ultrawide zoom lens from a friend and performed a perspective correction during post-processing in Adobe Photoshop. A commercial Fujifilm Frontier Digital Minilab was used to prepare 30 cm x 20 cm prints, which were distributed to congress delegates.

It was also a great honour to have had the opportunity on the day to meet Her Excellency Professor Marie Bashir, Governor of New South Wales and Chancellor of the University of Sydney. As an adolescent psychiatrist, Professor Bashir is highly regarded amongst medical students at Sydney Medical School and I found, during our conversation, that her reputation is indeed very much deserved.

Update (10 Feb 2008): Full-size NAPSA Congress Sydney 2008 photo now available for download.

Pregnancy category mnemonic

Kieren — Fri, 05 Oct 2007 07:27:54 +0000

It seems that most of us in the Sydney Medical School have become suckers for mnemonics… Recently, after the Problem 4.05 theme session on drugs in pregnancy, I came up with a mnemonic to help people remember the Australian Drug Evaluation Committee (ADEC) pregnancy categories used for medications in Australia.

Category A = A-OK – generally considered safe: Drugs which have been taken by a large number of pregnant women and women of childbearing age without any proven increase in the frequency of malformations or other direct or indirect harmful effects on the fetus having been observed. (ADEC, 2007)
Category C = Careful – may be harmful: Drugs which, owing to their pharmacological effects, have caused or may be suspected of causing, harmful effects on the human fetus or neonate without causing malformations. These effects may be reversible. Accompanying texts should be consulted for further details. (ADEC, 2007)
Categories B = Buggered if I know – limited data available: Drugs which have been taken by only a limited number of pregnant women and women of childbearing age, without an increase in the frequency of malformation or other direct or indirect harmful effects on the human fetus having been observed. (The allocation of a B category does NOT imply greater safety than the C category.) (ADEC, 2007)
Category D = Danger – risk of irreversible harm: Drugs which have caused, are suspected to have caused or may be expected to cause, an increased incidence of human fetal malformations or irreversible damage. These drugs may also have adverse pharmacological effects. Accompanying texts should be consulted for further details. (ADEC, 2007)
Category X = X-men – high-risk teratogens: Drugs which have such a high risk of causing permanent damage to the fetus that they should not be used in pregnancy or when there is a possibility of pregnancy. (ADEC, 2007)

Of course the use of drugs in pregnancy requires more than simply looking-up the ADEC pregnancy category, but the categorisation does prove quite useful as a quick reference in clinical practice.