CHPR

THE CENTRE FOR HEALTH PROMOTION AND RESEARCH

W O R K S H O P S

I N

Lifestyle Medicine and

Chronic Disease Management
For GPs, Practice Nurses and Allied Health Practitioners RACGP approved Continuing Professional Development (CDP)

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INTRODUC TION TO LIFESTYLE MEDICINE Background: Lifestyle Medicine is the application of environmental, behavioural, medical and

motivational principles to the management (including self care and self-management) of lifestylerelated health problems in a clinical setting (Egger, Binns and Rossner, 2009). This workshop introduces the concept of Lifestyle Medicine and the rationale behind it.
Content:

Background: An overview of Lifestyle Medicine Modern disease trends The disease hierarchy Lifestyle and disease Lifestyle Medicine frameworks
Motivation for Lifestyle Change

The anatomy of motivation The Stages of Change Model Motivational interviewing Other motivational strategies for change
Measuring Lifestyle Risks (practical)

Understanding risk factors Anthropometric measurement Other lifestyle measures for clinical use
Introduction to Management of Weight Control in General Practice

Causes of obesity Existing management strategies New and developing techniques Metabolic influences and how to deal with them
Prescribing and testing nutrition (practical)

Measuring food and activity causes of obesity New findings in nutrition carbohydrate; protein; fat; alcohol Exercise prescription for disease management Epidemiology of inactivity Generic exercise prescription Specific exercise prescription The 4 Ss: Stamina; Size; Suppleness; Strength

The School of Health and Human Sciences at Southern Cross University, in conjunction with the Australian Lifestyle Medicine Association (ALMA) and the Centre for Health Promotion and Research, offers approved workshops in Lifestyle Medicine for Australian GPs, practice nurses and allied health professionals. The following workshops are offered for single day weekend, weekday or weeknight presentation.

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L I F E S T Y L E M E D I C I N E A N D M O O D S TAT E S Background: This workshop introduces basic aspects of management of common mood states:

stress, anxiety and depression, as well as introducing techniques for promotion of positive mental health. It includes an expansion of relevant epidemiological issues for lifestyle management.
Content Introduction: Lifestyle Medicine and Mood States

Lifestyle related disorders Type 2 Diabetes, pre-diabetes and lifestyle Lifestyle and mood states
Practical: Measuring Body Fat

Anthropomorphic measures Bio-impedance measures

Motivation: Techniques of Influence

Habits: Hard-wired and learned Seven methods of influence Applying marketing principles to the clinical situation
Pervasive Causes

Nutrition and mood states Physical activity and management of mood states
Stress ( or Strain?) and Anxiety

Basic concepts of stress Physiology of stress Control and Escape the management of stress Physiology of anxiety Management tools
Depression and Happiness

Prevalence of depression Basic physiology Management tools Positive psychology and the concept of a happiness

What attendees say about Eduventures: the kayaking eduventure was a great learning experience Marion Goodman, Practice Nurse, Tamworth; a fantastic way to learn while enjoying the outdoors on a walk Dr Daniel Lewis; Rheumatologist, Melbourne; the Yuraygir walk and chronic pain workshop were superb Mary-Anne Cole, Managing Practice Nurse, Grafton

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P S YC H O L O G I C A L A N D E N V I R O N M E N TA L I N F L U E N C E S I N L I F E S T Y L E M E D I C I N E Background: This workshop explores a range of common environmental and psychological

influences in lifestyle practice. It covers the impact of modern lifestyles on sleep, injury and skin conditions, as well as approaches to measurement and assessment of these for referral.
Content

Oxidative stress, metaflammation and chronic disease Changing ideas about obesity and disease Inflammation and Metaflammation: The basis of atherogenesis Metaflammation, Type 2 diabetes and Gestational Diabetes
Nutrition and Exercise Update

Energetic factors influencing body weight Recent findings in nutrition Updating nutrition recommendations Updating exercise recommendations
Practical: Measuring lifestyle-related problems

Measuring body fat Skin health Sleep monitoring

Habits and Addictions

Understanding habits and their impact on health Behavioural and cognitive habits Habits relating to eating and drinking Environmental issues in skin care Basic anatomy of the skin and lifestyle Behavioural and environmental insults to the skin A skindex of problems and simple skin care package
Sleep and sleep disorders

Sleep facts Health impacts of sleep: too much and too little Sleep and metaflammation A sleep hygiene package

Associated Program The LM workshop program represents an abridged version of the Post Graduate Masters in Clinical Sciences (Lifestyle Medicine) offered by Southern Cross University. Advanced standing can be applied for by those successfully completing individual workshop units and wishing to extend to Post Graduate Certificate, Diploma or Masters level.

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LIFESTYLE MEDICINE, INFLAMM-AGEING AND ADDIC TIONS Background: New findings suggest that chronic, low-grade systemic inflammation underlies

all lifestyle-related causes of chronic disease. This extends to ageing and has been called inflammageing. It has also been associated with different forms of addiction. This workshop expands the role of Lifestyle Medicine into these areas.
Content Lifestyle facts and fallacies

Nutrition facts and fallacies Exercise facts and fallacies

Lifestyle related inflammation and inflamm-ageing

Inflammation in chronic disease The maladaptive environment hypothesis Teasing out the lifestyle-obesity link in chronic disease Inflamm-ageing: Immunosenescence with ageing
Thought processes, cognitive inflammation and mental health

Developing psychological immunity A 9-step process for changing damaging thought processes
Managing pain

Musculo-skeletal disorders, joint health and chronic pain Passive vs active strategies of dealing with pain Pacing for pain management Inflammation and sensitisation
Joint health

Injury The 5th S of fitness stability Core strength and stability

Dealing with addictive behaviours

Feelings from addictive behaviours The addiction pit Addiction and psychological chasm Trends in addiction treatment Workshops on the run (or walk or paddle)

Workshops are offered regularly as part of an Eduventure process walking remote desert trails or kayaking majestic lake lands over 4-6 days. You can have a tax deductable adventure while earning CPD points. Enquire for special courses and times on offer.

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SELF-MANAGEMENT AND LIFESTYLE MEDICINE Background: A core principle of Lifestyle Medicine is the need for the client or patient to become

active in his or her health care. This module describes a model for how this can by initiated by the clinician using a 3x3 matrix drawing from the best evidence-based approaches to selfmanagement.
Content Introduction and self-management quiz

A self management audit Self care and self management in Lifestyle Medicine Chronic Disease Self-Management (CDSM) and General Practice
The endothelium and chronic disease: A physiological basis for self-management

Inequality and health The vascular endothelium: Where the rubber meets the road Risk factors, treatments and CVD outcomes Self measurement
Rationale, background and models of self-management

Practice principles for Lifestyle Medicine Why self-management? Evidence for CDSM Structure of good self-management

Approaches to self-management: 1. Being client-centred

Basic principles Reflective listening: reading body language Increasing health efficacy

Approaches to self-management: 2. Being motivation focused

Basic principles Motivational interviewing basic principles Being ready, willing and able to change

Approaches to self-management: 3. Being health literacy oriented

Facts on health literacy Assessing clinical health literacy Practice tips for improving health literacy Specific Chronic Disease Self-Management health literacy

What attendees say about the clinics: has changed the way I deal with patients. Dr Tony Andrew, Cremorne, Sydney very innovative, state of the art information. Dr Andrew Binns, Lismore, NSW a truly useful program. Dr Ke Teoh, Greenfield Park, Sydney

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L I F E S T Y L E M E D I C I N E A N D C H R O N I C PA I N Background: Chronic, unexplained pain has increased dramatically in recent years. Traditional

treatment methods have limited success and hence this workshop considers physiological findings that implicate lifestyle factors in neural changes and how these might have an influence. A triaging system for primary care is also considered to help reduce the demand on the limited specialist pain clinics.
Content Epidemiology of chronic pain

History of pain Chronic pain as a modern phenomena Types of pain?

Metaflammation and chronic pain: a new perspective

Physiology of pain Pain and chronic pain Pain and glial cell involvement Does all chronic pain involve systemic inflammation?
A whole person approach to chronic pain

Management approaches Alternative treatments: medial and other Neural plasticity: Retraining old neural patterns
Lifestyle approaches 1. Nutrition

Nutrition, inflammation and pain Specific aspects of nutrition Physiological effects of nutrition Is there such a thing as foods to reduce pain?
Lifestyle approaches 2. Exercise

Exercise for pain reduction Prescribing generic exercise for pain Prescribing specific exercise for pain
Pain and mind/body medicine: The ideal situation

Exercise for pain reduction Targeted procedures Measuring pain

Chronic diseases surpass infectious diseases in prevalence once a country achieves a certain level of economic development. This happened in western countries in the later half of the 20th century and is now happening in rapidly developing countries like India and China. Chronic pain appears to be a bi-product of such a process, with enormous consequences for health costs.

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L I F E S T Y L E M E D I C I N E F O R D O C T O R S A N D H E A LT H W O R K E R S Background: While doctors and health care workers spend their time looking after others, they

often ignore their own health. This workshop covers aspects of Lifestyle appropriate for getting and maintaining good health for those at the front line of modern health care.
Working on the inflammatory front line

Lifestyle and health at the coal-face Metaflammation in the workplace Prioritising heath
Practical:

Anthropometry Red flags to look for in health workers Measuring chronic disease early stages
Risk factors for health workers

The 3 Ss: Stress, Sleep and Social Relations The 3 Fs: Forks, Feet and Fingers The risks of being inactive and how to overcome them Slow food for fast workers
Front line health care: All stressed up with no-where to go.

Recognizing brown out and preventing burn out The ACT program for stress management Anxiety and depression: Diagnosis and action
Sleeping with the enemy.

Sleep hygiene upgraded Common sleep disorders amongst health care workers Managing sleeplessness or daytime sleepiness The sleep of others: in bed with a snorer/poor sleeper

Anxiety is a thin stream of fear trickling through the mind. If encouraged, it cuts a channel into which all other thoughts are drained. Arthur Sommers Roche

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L I F E S T YL E M E D I C I N E, S YS T E M S T H E O RY A N D W E I G H T LO S S Background: Almost two-thirds of Australians are now classified as overweight or obese. And

while diet and exercise programs abound, few understand the complexities of weight control in an obesogenic environment. This module looks at new findings on obesity and weight control and their practical implications.
Is fat the problem? The physiology of obesity-related disease

Levels and forms of obesity management New findings about the adipocyte Obesity paradox(es) and the fat spill-over hypothesis
Practical

Measuring fat not weight and health, not fat Estimating ideal weight Measuring obesity risk/measuring lifestyle risk
Systems theory and weight loss

Thinking in circles: Why a calorie is no longer a calorie What we now know about the gut: food harvesting and efficiency Strategies and methods in weight-related disease management
Processes for weight loss

A LM toolbox for weight loss/risk factor change Setting SMART goals Individualising weight loss: medications/surgery/lifestyle Reducing the risks: NASTI DR
Debunking weight loss myths

Myths, presumptions and facts

Group consults a new process for obesity management

The nuts and bolts of group consults.

As author of Planet Obesity: How we are eating ourselves and the planet to death, Dr Garry Egger is one of the worlds authorities on the big picture as well as small detail for weight loss.

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L I F E S T Y L E M E D I C I N E A N D E V I D E N C E - B A S E D C O M P L E M E N TA R Y M E D I C I N E Background: There is a wide gulf between orthodox and complementary medicines. However,

some of the best aspects of both have relevance for the processes of lifestyle medicine. This workshop discusses evidence-based research on relevant aspects of complementary medicine and its use in lifestyle medicine.
Why complementary medicine?

Definitions and history Lifestyle and chronic disease Processes in complementary medicine research The market for complementary products
Practical

Natural health products: The evidence for and against

Physical activity in lifestyle and complementary medicine

Exercise as therapy Activity prescription Components of fitness Food supplements and exercise enhancement

Nutrition: the orthodox and complementary views

Basic theory Food and health: Specific prescriptions Health problems amenable to nutrition changes 1. T2DM Health problems amenable to nutrition changes 2. Heart risks Herbs and health
Stress: an alternative approach.

Behavioural approaches from naturopathy The evidence for natural products: SAMe; St Johns Wort etc. Dealing with depression

While there is controversy about many alternative health practices, ~80% of the population use these at some stage. Hence it is better for health workers to understand the reasons chosen for going down this path than to deny that the path is used.

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IMPROVING OUTCOMES AND INCOMES FROM BET TER CHRONIC DISEASE MANAGEMENT Background: While lifestyle approaches to disease management might seem logical, the

bottom line is that these have to be both effective and financially viable. This workshop shows how to improve both health outcomes, and clinical incomes from using an evidencebased lifestyle medicine approach and a more efficient use of options within the chronic disease management system.
Lifestyle Medicine and chronic disease

The what and why of lifestyle medicine Anthropogens in the etiology of chronic disease Content in lifestyle medicine
Improving patient outcomes: Making LM work

Defining success in chronic disease management What works, what doesnt? Techniques and processes for improving outcomes Processes in lifestyle medicine
Improving clinical incomes: Making LM pay (1)

Reducing costs to increase incomes

Practical

Case studies using current payment systems better

Improving clinical incomes: Making LM pay (2)

Group consults (Shared Medical Appointments): A new concept for chronic disease management SMAs, PSMAs and DIGMAS: The 3 main forms Physical requirements Group consults in the Australian context
Improving clinical incomes: Making LM pay (3)

The nuts and bolts of running group consults in your practice Team and training arrangements Medicare arrangements and billing for group consults

Through better (and legitimate) use of the existing Medicare system you can potentially: Get better health outcomes Improve patient compliance Improve patient self-management Improve clinical incomes Reduce hospital admissions Successfully utilize peer support mechanisms Increase patient /provider satisfaction.

COURSE LEC TURERS INCLUDE: Professor Garry Egger PhD, MPH, MAPS AM Dr Joanna McMillan B Hum Nutr., PhD

Professor of Health and Human Sciences at Southern Cross University, and consultant to the NH&MRC and WHO on chronic disease. (Workshop co-ordinator)
Dr Caroline West MB BS (GP and Media Doctor)

Joanna is a registered nutritionist and dietitian with a PhD in nutritional science. She is also a trained tness instructor with almost twenty years experience.
Gary Webb B Hum Movt., MSc

Dr Caroline West is a GP with a special interest in lifestyle medicine. She has extensive experience conducting workshops for allied health professionals, corporate and community groups in lifestyle medicine and self care.
W O R K S H O P D E TA I L S

Gary is an Exercise Physiologist with a particular interest in nutrition, public health and lifestyle medicine. He is currently undertaking a PhD addressing the upstream causes of lifestyle disease.

Time: Workshops are six hours in duration (to receive full CPD points) and are generally conducted over one day of a weekend. However 2x nightly meetings can be arranged if required within Medicare Locals. Costs: Where possible sponsorship is sourced to provide these workshops. In the event of sponsorship not obtained, workshops can be provided at participant cost. RACGP Requirements: Requirements for CPD points (40 Category 1) include completion of a pre and post-test (reinforcing) activity as well as attendance at workshops. Other professionals can obtain specic CPD points approval through their associations.

m 0414 726 773 e ceo@lifestylemedicine.com.au w www.lifestylemedicine.com.au