Managing panic disorder in general practice

BACKGROUND: Panic disorder (PD) is common in the community and contributes to significant distress and decreased quality of life for people who suffer from it. Most people with PD will present in the first instance to their general practitioner or hospital emergency department for assistance, often with a focus on somatic symptoms and concerns.

OBJECTIVE: This article aims to assist the GP to manage this group of patients by providing an outline of aetiology, approaches to assessment, and common management strategies.

DISCUSSION Although GPs have an important role to play in ruling out any causal organic basis for panic symptoms, the diagnosis of PD can usually be made as a positive diagnosis on the basis of careful history taking. Thorough and empathic education is a vital step in management. The prognosis for PD can be improved by lifestyle changes, specific psychological techniques, and the judicious use of pharmacotherapy.

Making decisions about fertility : three facts GPs need to communicate to women

Background Average annual fertility rates in industrialised countries have been below two children per woman for the past 3 decades. The reasons behind women’s childbearing behaviour are complex. However, a lack of awareness regarding the consequences of delayed childbearing and the inability of reproductive technologies to overcome the ‘biological clock’ may be contributory factors.

Objective A narrative review guided by the research question: What do women need to know about the consequences of delayed childbearing in order to make informed decisions about their fertility?

Discussion There are three facts that women need to know in order to make informed decisions around their fertility: Some women want to have more children than they are able to have because they postpone childbearing; there can be medical consequences to delaying childbearing and; some women’s ideas about their fertility don’t match the ‘the scientific facts’. General practitioners are well placed to play a strategic role in the provision of timely, relevant information to help women make informed decisions about their fertility. Further research is needed to identify the most appropriate ways for GPs to communicate this information.

Game Sense as a model for delivering quality teaching in physical education

As a well-developed indicator of high-quality teaching in any subject area we use the New South Wales (NSW) Quality Teaching Framework (QTF) in this article to identify what might constitute quality teaching in physical education and to suggest the extent to which Game Sense pedagogy can be seen to meet the expectations of the NSW QTF. We identify and discuss the pedagogical features of Game Sense that our examination suggests can provide quality teaching and learning to make suggestions about how this could inform the provision of high-quality teaching across the practical curriculum.

How are Australian higher education institutions contributing to change through innovative teaching and learning in virtual worlds?

Over the past decade, teaching and learning in virtual worlds has been at the forefront of many higher education institutions around the world. The DEHub Virtual Worlds Working Group (VWWG) consisting of Australian and New Zealand higher education academics was formed on 2009. These educators are investigating the role that virtual worlds play in the future of education and actively changing the direction of their own teaching practice and curricula. 47 academics reporting on 28 Australian higher education institutions present an overview of how they have changed directions through the effective use of virtual worlds for diverse teaching and learning activitiessuch as business scenarios and virtual excursions, role-play simulations, experimentation and language development. The case studies offer insights into the ways in which institutions are continuing to change directions in their teaching to meet changing demands for innovative teaching, learning and research in virtual worlds. This paper highlights the ways in which the authors are using virtual worlds to creat opportunities for rich, immersive and authentic activities that would be difficult or not possible to achieve through traditional approaches

e-Mental health for mood and anxiety disorders in general practice

Background Australia is a world leader in the development of internetdelivered programs for the prevention and management of mood and anxiety disorders. Despite a strong evidence base of time- and cost-effectiveness, as well as clinical efficacy, the uptake of these programs in general practice remains low. Objective To familiarise general practitioners (GPs) with the range of online programs in Australia that have demonstrated efficacy and are currently available for use by patients with mental health problems. Discussion E-mental health programs provide an efficacious and accessible form of mental healthcare and have the potential to fill the gap for those for whom such care is inaccessible, unaffordable or unacceptable. Clinicians can also use it in a stepped-care manner to augment existing healthcare services. There are a number of online resources currently available to Australians who have mood or anxiety disorders. These resources have strong evidence to support their effectiveness. Online portals facilitate access to these programs. Recently the Australian Federal Government has funded an education program (eMHPrac) for GPs and mental health professionals, to outline what is available, indicate situations where recommending such resources is appropriate, and suggest ways in which they can be incorporated into general practice.

Constructing knowledge

The most popular model of how students learn is known as the constructivist model of learning. There are variants of this model, but the main features are that learning occurs in the context of pre-existing experiences and ideas, that new concepts are transformed to fit or build on those existing ideas, and that learning occurs in a social or cultural context. Learners are not empty vessels, into which new knowledge can be injected. New concepts, which are consistent with and extend pre-existing experiences and ideas, are easily and effectively assimilated. Learning is difficult, when learners have pre-existing incorrect ideas or alternative conceptions, as they must first unlearn the misconceptions in order to incorporate the new information. In a different context, it is usually much harder and more expensive to retrofit an existing house than to build from scratch. Similarly, it is very hard to overcome bad habits. A previous column in Chemistry in Australia [July 2013, page 35], noted that we simplify ideas when teaching chemistry to younger students, but warned that over-simplication often results in misconceptions that will hinder future learning. Most chemistry educators favour constructivism, because there are similarities with the process of discovery in science. Firstly, the advancement of scientific knowledge builds on past experiences and knowledge: Isaac Newton famously acknowledged, “If I have seen further it is by standing on the shoulders of giants”. Secondly, observations and data of themselves are not meaningful, until that information has been transformed to extend existing ideas: Nobel Laureate Lawrence Bragg wrote, “the important thing in science is not so much to obtain new facts as to discover new ways of thinking about them”. Science as a Human Endeavour (SHE) is one of the strands in the Australian Curriculum. Similarly, one of the learning outcomes in the Draft Chemistry Academic Standards is that graduates will be able to recognise the creative endeavour involved in the acquiring knowledge and to recognise the testable and contestable nature of chemistry. Science is practiced individually and collectively by people. Human beings, who have human virtues and fallibilities, are responsible for scientific advancements. New knowledge is constructed in the minds of learners and scientists. Just as discussions in work teams, workshops, conferences, and the scientific literature, help scientists to extend and improve scientific understanding, the important role of teachers is to guide students to refine, alter and improve their scientific understanding when extending their scientific boundaries.

A community college's performance of 'organisation' : it's a drag!

Noting the ever-increasing encroachment of discourses and practices from the private sector on public education providers, this paper argues that such organizations exist within competing sets of differences that seek to define and fix the meaning of 'education' and 'business'. We report on fieldwork conducted in an adult education college in Sydney. In the Australian context these colleges are referred to as community colleges and their history is one based in a strong liberal tradition. Utilising Judith Butler's idea of 'drag' we consider the effects of changing modes of governance in the college with specific reference to the stories told to us about it. Our discussion suggests that the organisation was caught between identifying itself with a masculinised discourse of business and a discourse of community cast as its feminised other. In navigating between these, the college was seen to perform as a 'drag king' — an organisation performing the masculine but in so doing, undoing its gendered status. This leads us to suggest that the incorporation of business and market-based discourse into the management of community education is something that is actively resisted and undermined through such forms of gendered transgression. We conclude by proposing that this organization's capacity to perform drag is a contributing factor to its overall success, and particularly in an economic climate where many not-for-profit organisations are floundering

The struggle to technicise in education policy

In contemporary education policy, simplified technical accounts of policy problems and solutions are being produced with the use of numeric calculations. These calculations are seen as clear and unbiased, capable of revealing ‘‘what works’’ and identifying ‘‘best practices.’’ In this piece, the authors use resources from the materialsemiotic approach of actor-network theory to discuss how calculations have begun to serve as a subtle infrastructure underpinning the way we understand and organise our world. They demonstrate the usefulness of the approach in tracing the technicisation of policy by deploying it to qualitative studies of like-school comparisons in the two unexpectedly linked locations—New York City and Australia. The authors reveal how technical accounts are precarious and need constant maintenance to endure, even as they increasingly becoming routine, curtailing the policy imagination and limiting the spaces of contestation. It is for this reason, they argue, that a deeper understanding and sustained critique of such accounts is of pressing importance.

Perceptions of ad hoc supervision encounters in general practice training: a qualitative interview-based study

BACKGROUND: Ad hoc supervision encounters occur between general practitioner (GP) supervisors and general practice registrars outside scheduled teaching sessions. Anecdotally reported as important learning opportunities, these encounters are rarely explored in the literature. OBJECTIVE: This study examined supervisors', registrars' and practice managers' perceptions of ad hoc supervisory encounters. METHODS: Semi-structured interviews were conducted with purposively sampled supervisors, registrars and practice managers from regional general practice settings. Data were analysed using template analysis. RESULTS: Fifteen respondents participated in the interviews. Their perceptions of ad hoc encounters were reported under the categories of immediacy, safety, education, professional identity and supervisor stress. DISCUSSION: Ad hoc encounters in general practice registrar training are highly valued for supporting patient safety and registrar education. The encounters serve a range of practical purposes for supervisors, registrars and practices, and warrant further exploration on how to optimise their benefits within general practice.

Mental health system development in Asia: does Australia have a role?

BACKGROUND: Socioeconomic trends herald what many describe as the Asian Century, whereby Asian economic, political and cultural influence is in global ascendency. Broadening relevant ties between Australia and Asia is evident and logical and may include strengthening alliances in mental health systems. AIM: We argue the importance of strengthening Asian mental health systems and some of the roles Australian mental health workers could have in promoting strengthening the Asian mental health system. METHODS: This paper is a narrative review which sources data from reputable search databases. RESULTS: A well-articulated Australian strategy to support strengthening the mental health system in Asia is lacking. While there are active initiatives operating in this space, these remain fragmented and underdeveloped. Coordinated, collaborative and culturally respectful efforts to enhance health education, research, policy, leadership and development assistance are key opportunities. CONCLUSION: Psychiatrists and other mental health professionals have a unique opportunity to contribute to improved mental health outcomes in Asia.

Book review: Review of 'John Connor, Anzac and Empire: George Foster Pearce and the Foundations of Australian Defence' (Melbourne: Cambridge University Press), 2011. ISBN10 1107009502 (Hb) pp. 248. $59.95, cloth.

Anzac and Empire is the remarkable story of George Foster Pearce – a carpenter who became one Australia's most influential politicians, and the man central to how Australia planned for, and fought in, World War I. The nation's longest-serving defence minister – holding the portfolio before, during and after the Great War – Pearce saw no contradiction in being both a fierce Australian nationalist, and also a loyal subject of the British Empire.Anzac and Empire is the first full-length biography of this extraordinary Australian. Written by one of Australia's leading military historians, this book shows that to understand Australia in the Great War, you must understand the man behind it.

‘What else can I do?’ Radical suggestions to help physical education teachers successfully implement a game based approach to teach games

As with any new relationship when teachers implement a different or unfamiliar pedagogical approach into the classroom it is often accompanied by a period of unaccustomed behaviour; such as a reluctance for teachers to commit or a wariness from learners to invest or reveal. The challenges that teachers and learners face in the initial stages of this new relationship, if overcome, can be the mainstays of a mutually beneficial learning experience. Yet, as many teachers have experienced, the reverse of this is also true. Failure to adequately invest, plan and commit to the introduction of a new pedagogical approach can bring with it long term consequences that include an unwillingness to ever start a new relationship again.