Vaccine hesitancy: Margie Danchin at DFTB18

Cite this article as:
Team DFTB. Vaccine hesitancy: Margie Danchin at DFTB18, Don't Forget the Bubbles, 2018. Available at:
https://doi.org/10.31440/DFTB.17112

This talk was recorded live at DFTB18 in Melbourne, Australia. With the theme of ‘Science and Story’ we pushed our speakers to step out of their comfort zones and consider why we do what we do. Caring for children is not just about acquiring the scientific knowhow but also about taking a look beyond a diagnosis or clinical conundrum at the patient and their families. Tickets for DFT19, which will be held in London, UK, are now on sale from www.dftb19.com.

How to draw a Genogram

Cite this article as:
Daniel Bakhsh. How to draw a Genogram, Don't Forget the Bubbles, 2018. Available at:
https://doi.org/10.31440/DFTB.17132

As a Student Doctor at the University of Queensland, I was offered the opportunity to shadow the Adolescent Team at The Child and Youth Mental Health Service (or CYMHS) at the Queensland Children’s Hospital. This was an amazing opportunity to observe some really important work in two of my special interest areas: Paediatrics and Psychiatry. The attachment really drove home that patients don’t exist in isolation, and how this is particularly true for children. The surrounding family system strongly dictates how well they will fare once they leave the hospital.

As part of this attachment I was asked to prepare and present Genograms for every patient at the weekly Multidisciplinary Team meeting. As I began to interview family members in order to gather the required 3 generations of family history, it became clear to me that a small diagram could represent and quickly convey what would otherwise have taken several pages of text. Genograms provide a wealth of insight at a glance, can help align patients with their most appropriate care, and are relatively easy to draw once you know how. They are a mainstay of Paediatrics for a reason.

When I first came across Genograms as a student, attempting to create one was very confusing and a little overwhelming. There are also surprisingly few reference materials available to aid you along the way. So in order to make this task a little easier for the next student, I put together this little video. I hope you find it useful.

– Daniel Bakhsh, Student Doctor, Doctor of Medicine Program, University of Queensland

DFTB go to New York

Cite this article as:
Andrew Tagg. DFTB go to New York, Don't Forget the Bubbles, 2018. Available at:
https://doi.org/10.31440/DFTB.17016

I first heard of the FemInEM crew in Dublin. Dara Kass, Jenny Beck-Esmay and Stacey Poznanski took to the stage to talk about the birth of FemInEM, first as a blog then as a resource to effect change in the conversation around gender and equity in emergency medicine. Since then they have grown to be a leading voice in this area.

Their first sell out conference, FIX17, in New York brought together a unique set of voices and when the call came out for pitches to speak at FIX18 I thought it would be the perfect place for me to tell a story. This blog post isn’t about my tale – you can read A short story about deathand life here – but about something else.

I consider myself well-travelled, having spent almost 5 years of my life working as a doctor on board cruise ships, but hearing the talks at FIX18 made me realise I a still living in my own little bubble. Everything I hear via Twitter or other forms of social media comes pre-filtered by the source. So if I only follow white hetero-males they inform my worldview. The conference reminded me that there are other voices and other realities.

 

Sex and gender

In a conference where I was clearly in the minority, I was constantly reminded of things I have just taken for granted. Nick Gorton, a transman,  really opened my eyes when he told the audience that life had been like playing a video game on hard mode then, when he became a man, everything just switched over to easy. Look out for his great talk when it comes out…

 

Race

You only have to read the newspaper headlines on any given day to see how race plays a role in the public perception of a person. To hear Arabia Mollette say that she will never be seen as a woman first when she walks into a room because she is a person of colour made me feel uncomfortable. I’d like to think that I don’t see the world that way, but we all have our implicit biases. Don’t think you are biased? Then try out one of the Harvard Implicit Bias tests over at Project Implicit.

 

Privilege

A lot of medics come from a place of privilege, parents with degree level education and jobs that pay well. Many have parents that are, or were, doctors.  Regina Royan spoke of a different type of upbringing, of families struggling to make ends meet, and of the hidden challenges this brings from the start of medical training – not just in the shockingly high costs to apply to medical school in the US but also on things like electives and placements away from your home base.

 

I have lived, comfortably, within my own little bubble of existence. FemInEM has challenged me to expand my worldview, to listen to dissenting voices, and ask more questions.

 

For more accounts of FIX18 then read these accounts…

Penny Wilson – Getting my feminist FIX in New York

Shannon MacNamara – Telling stories to FIX things

Annie Slater – We support, We Amplify, We Promote

 

Preventing Poisonings in the Home

Cite this article as:
Joe Rotella. Preventing Poisonings in the Home, Don't Forget the Bubbles, 2018. Available at:
https://doi.org/10.31440/DFTB.16269

You’ve just seen a young lady who managed to swallow a tablet out of Grandma’s handbag, whilst she was over for a visit. Luckily, it was a 20 mg esomeprazole tablet so she’s going to be ok. You go in and reassure her worried family that nothing further will occur. Feeling your job is done, you turn to leave but then her mother asks you ‘How can we prevent this happening in future?’.

What would you say?

Ross Fisher: What surgeons wish you knew from DFTB17

Cite this article as:
Team DFTB. Ross Fisher: What surgeons wish you knew from DFTB17, Don't Forget the Bubbles, 2018. Available at:
https://doi.org/10.31440/DFTB.16201

This talk was recorded live on the final of DFTB17 in Brisbane. If you missed out in 2017 then why not book your leave for 2018 now. Tickets are on sale for the pre-conference workshops as well as the conference itself at www.dftb18.com.

What more can be said about Ross Fisher that hasn’t already been said? Passionate presenter, good (but not perfect*) surgeon and friend to the stars – in this talk Ross delves into the hidden world of paediatric surgery.

Paediatric Research Priorities

Cite this article as:
Andrew Tagg. Paediatric Research Priorities, Don't Forget the Bubbles, 2018. Available at:
https://doi.org/10.31440/DFTB.16058

In order to help us all keep up to date the DFTB team and friends scour a great many journals to fill the monthly edition of Bubble Wrap. Given the large volume of research already out there that has not made it from the journal to the bedside, the major research agencies have been trying to determine what we really want to know.

Facing the future: standards for children in EM settings

Cite this article as:
Tessa Davis. Facing the future: standards for children in EM settings, Don't Forget the Bubbles, 2018. Available at:
https://doi.org/10.31440/DFTB.16004

Today saw the launch of the new RCPCH ‘Facing the Future’ document – setting standards for paediatric emergency care in the UK. These are a set of standards that should apply to all Emergency Department where children are seen and assessed.

Jonny Taitz: Patient Safety at DFTB17

Cite this article as:
Team DFTB. Jonny Taitz: Patient Safety at DFTB17, Don't Forget the Bubbles, 2018. Available at:
https://doi.org/10.31440/DFTB.15912

This talk was recorded live on the final day of DFTB17 in Brisbane. If you missed out in 2017 then why not book your leave for 2018 now. Tickets are on sale for the pre-conference workshops as well as the conference itself at www.dftb18.com.

DFTB go to the Academy

Cite this article as:
Leo, G. DFTB go to the Academy, Don't Forget the Bubbles, 2018. Available at:
https://dontforgetthebubbles.com/dftb-go-academy/

Attending a first-time conference is a bit like watching a softball match as a much talked-about rising ‘star’ batter comes onto the field to face-off against a seasoned pitcher. Will they strike a home run or will they simply get struck out? Most want the batter to do well and may even expect it – but there is the sense of anticipation and uncertainty in the air until that moment in time when the bat and ball connect and the latter goes flying.

The Academy of Child and Adolescent Health held its official launch on the 1-2nd of March at the Royal Children’s Hospital in Melbourne and Henry and Grace were lucky enough to be able to attend. The ACAH is a non-profit organisation founded with the purpose of “promoting the health and well-being of every newborn, child and adolescent in order that they may reach their maximum potential”. This concept grew out from a RACP focus group though the ACAH is open to all health professionals. The conference focused on key issues related to child and adolescent health. It also explored the ways that the ACAH may be able to make a difference in the areas of education, policy making and advocacy.

Day 1:

Keynote

One of the highlights of the ACAH morning session was the keynote by Kim Oates. He discussed some of the key areas he thought the ACAH might address in the future including indigenous and refugee healthcare, domestic violence (and child maltreatment), patient safety, parenting support and culture in healthcare.

ACAH board and strategic directions

Of particular note during the morning session, the entire board came to the front and introduced themselves and fielded questions about the ACAH and their involvement to date. In the afternoon there was also a review of the strategic planning day which involved multiple paediatric subspecialty groups discussing some of the steps the ACAH might make to become a central hub that strengthens and utilises the skills and resources in these other organisations in addition to producing its own material.

Living with disability

The midday session featured a fantastic panel on navigating disability. One speaker who particularly impressed us with Jacki (Jax) Brown who spoke on how the way that disability affects and encompasses each individual uniquely. She also raised the importance of considering wheelchair accessibility of events, healthcare venues, work and public transport. Simply being labelled “Wheelchair Accessible” does not mean that a building is wheelchair friendly. Sometimes it might be a separate entrance around the garage which requires buzzer accessmaking the people using it feel excluded. Jax asked us to model inclusion and not ignore disability when we see it – but to respect people living with disabilities, remember that they have value and enable them to define for themselves who they are and what their identifies are. She also encouraged a move away from treating people with disabilities as passive receivers needing to ‘justify’ their needs, but rather to engage and work together with people with disabilities on the structure and social barriers that are causing problems for equity.

Asylum seekers, children in detention

The afternoon session was divided into a presentation from Megan Mitchell – the National Children’s Commissioner and a strategic planning session. This  encouraged delegates to add their thoughts regarding the future direction of the ACAH. Megan Mitchell’s talk focused on presenting the findings from the recent report into Asylum Seekers, Refugees and Human Rights. She pointed out that Australia has now been elected to the UN Human Rights council for the next three years and that this could be a critical time to uphold and support the human rights of asylum seekers, refugees and indigenous populations in Australia. After many years, Australia has finally committing to ratify OPCAT (Optional Protocol to the Convention Against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment). OPCAT should apply to all places of detention in Australia, including prisons, juvenile justice and mental health facilities, and immigration detention. Megan shared her experiences talking with children in Australia and offshore centres ias well as some of the terrible conditions children have been subjected to – conditions such as having hygiene products withheld for misbehaviour and placing children in prolonged isolation for up to 20 hours a day. These methods of discipline have been teaching children that the abuse of others, especially those less powerful, is normal. It is also likely to be traumatising already vulnerable children and adolescents.

Overall verdict after day 1:

Although the ACAH provided no ground-breaking change in terms of the experience compared with more traditional conference – we still enjoyed it. The talks were, for the most part, on-point. There was a good buzz and question time for every talk was filled without difficulty.

 

Day 2

If the first day of the conference is like the time a batter comes to the plate, the second day of a conference is the bottom half of the game. It’s all about finding and keeping the lead. It’s also a nice part of the game because there’s momentum to play off and you’re more familiar with and more invested in the delegates and topics as whole.

Human Digital Interface of Healthcare

This morning session opened with Gareth Baynam discussing digital diagnosis and the search for answers for children suffering from rare diseases. Kath Carmo discussed the value of telemedicine used by the NETS team in retrieval to help guide support and make decisions about transfers. She also explained the importance of retrieval of sick kids in having equitable access to healthcare. James Dromey’s talk was focused on future digital platforms and the way that healthcare can work with IT and tech companies to create new software and hardware to help with preventative medicine and provide education for both healthcare workers and families. He honed in on the importance of product development which doesn’t just ‘sound’ like a good idea – but which is user-centred and has both proof of concept and sustainability.

Advocacy & Global Health

The second session was an intriguing look into how the American Academy of Paediatrics, the UK RCPCH and the Paediatric Society of Australia and New Zealand have grown and developed their role in advocacy and global health. The importance of engaging members and using multiple different approaches in advocacy was stressed. Another element in the early afternoon session was a thoughtful speech from Dame Quentin Bryce who officially launched the ACAH and reaffirmed key areas in need of advocacy such as indigenous health, adolescent health, supporting research and the value in engaging whole families in care for children.

Safe Spaces for Children

The last session for the meeting was broad but interesting –  relating to the areas of social media, dealing with violence and providing a legal perspective on children and media. In particular, Donna Cross shared the interests of CoLabforKids and discussed the need to appreciate the nuances of managing screen time and social media. It is not enough to simply say that children should only have X amount of screen time; rather it is important to also look at the quality of the time and use. For example –  Is it watching movies in the car or is it with grandma reading an interactive online story book? The latter is much more likely to be beneficial to learning. On the topic of cyber-bullying and social media use – Donna made a great analogy to water safety. Swimming pools are both beneficial but dangerous. Children and adolescents need training, supervision, appropriate barriers and supports to safely enjoy and utilise them.

Overall Impressions

The ACAH launch was relatively small but filled with many experienced and respected individuals. There was a keen sense of anticipation in the air and thoughtful debate around key issues of advocacy. There were a number of strong speakers but I particularly liked disability panel and thought it worked well. It was very good to see patient and family representation at the conference. The ACAH team also showed a willingness for transparency and utilising a grass-roots approach. This was seen through the opportunity for discussion during and between the conference about the ‘where to from here’ and brainstorming of opinions about areas for priority and methods that might be employed. The majority of delegates were paediatric consultants although a few GPs also attended. It would be good to see further diversity in the board, speakers and delegates across health professionals given the aim and goals of the ACAH. The conference validated, in my mind, both the great need and opportunity for an organisation like the ACAH and I found myself registering for membership by the end of it. Whilst they may have won the game, there are many more matches to come. It will be of the great interest to follow how the ACAH board and members make good on their intentions from this launch in the next few months.

For more on the ACAH or to join membership check out www.acah.org.au

 

Norman Swan: Breaking boundaries in medicine at DFTB17

Cite this article as:
Team DFTB. Norman Swan: Breaking boundaries in medicine at DFTB17, Don't Forget the Bubbles, 2018. Available at:
https://doi.org/10.31440/DFTB.15288

This talk was recorded late on the second day of DFTB17 in Brisbane.

Norman Swan is a multi-award winning broadcaster and producer. He has one three Walkey awards for national journalism and in 1989 he was given the Michael Daly award, Australia’s highest prize for science journalism. In this amazing talk he takes us through his formative years as a junior doctor, on to his role in exposing the scientific fraud of Dr William McBride, and beyond.

DFTB go to South Africa

Cite this article as:
Tagg, A. DFTB go to South Africa, Don't Forget the Bubbles, 2018. Available at:
https://dontforgetthebubbles.com/__trashed/

When Annet Alenyo Ngabirano spoke about Ubuntu at DasSMACC one of things everyone wanted to know was how could they help. There was talking about donating to Supadel or supporting African academics and writers . Another suggestion was for those of us who ware lucky enough to get a study budget to go to Africa and share our knowledge and experience. When Kat Evans came to Brisbane last year to speak at DFTB17 she was very excited about her upcoming secret project.