Andréas' Medical Podcast Andréas Astier

It is quick, easy-to-use and is a structured method to describe, assess and observe your patient psychological functioning and mental state.

At the end of the MSE, you should have a relatively detailed description of key aspects of your patient mental state which should be written in a concise and paragraph like manner. It should be mentioned that an MSE should be made every time the patient comes and see the consultant/clinician. This is particularly useful as a history of MSE can then be made and compared to one another. By doing so, we can notice if things are improving or declining as a whole or in each segment of the MSE.

The MSE works hand in hand with the 4P factor model formulation; hence if you do both, you would a get a clear picture of your patient’s past and current life. This would allow the clinician to make a sound diagnosis, follow-ups, formulations and patient management for recovery. This includes the best course of action such as which therapy is needed, if medication needs to be started, if there is a need for referrals to certain support groups or specialists and so on. In a way, the MSE is the physical examination of the mind and is very useful, be sure to study and practise for a seamless and successful consultation!

Here, I decided to put together their differences and similarities as I found to be useful to distinguish between each other, especially since they have different medical usage.

It is quick, easy-to-use and is a structured method to describe, assess and observe your patient’s narrative into a coherent and concise record. Unlike the MSE which focuses on the psychological functioning and mental state of your patient, the 4P factor model formulation focuses on the collateral information of your patient and how they got to this point. This involves the past and the present of your patient where generally the MSE is more involved in the ‘now’. In other words, the 4P factor model formulation utilises four types of influences and the biopsychosocial risk factors. These influences and biopsychosocial risk factors shape the progression and development of mental health disorders for a particular patient.

In a nutshell: “The formulation asks what is wrong, how it got to that way, and what can be done about it” (1).

At the end of the 4P factor model formulation, you should have a relatively detailed description of key aspects of your patient’s narrative, what is going on in their lives and their risk factors. The 4P factor model formulation works hand in hand with the MSE; hence if you do both, you would a get a clear picture about your patient’s past and current life, and about their psychological functioning and mental state. This would allow the clinician to make a sound diagnosis, follow-ups, formulations and patient management for recovery. This includes the best course of action such as which therapy is needed, if medication needs to be started, if there is a need for referrals to certain support groups or specialist and so on. These are very useful in psychological consultation, so be sure to study and practise for a seamless and successful consultation!

The focus is on Palm Island, a rural community, with either a prevention or management plan of a certain disease that has a detrimental cause on the island. This chapter will focus on the management of sexually transmitted disease with a focus on syphilis on Palm Island, Queensland, Australia.

The further I researched Palm Island, the more I discovered how different it is to Australia. Palm Island could be described almost like a third world country with a high amount of a younger population and almost no one above 65 years old. Education and health is low and behind compared to Queensland which is only a 20 minute airplane flight. Palm Island has a lot of issues that needs to be addressed which is difficult when the socio-economic status is very low.

Before I was born, my father planted a couple of theobroma cacao tree also known as the cacao tree. Standing about 4 to 8 meters tall the cacao tree is described as an evergreen tree and is part of the malvaceae family which is native to tropical regions of the Americas. The seeds looks like a brownish fat bean and there are about 20 embedded in a weird wet and soft slime-like white pulp (apparently it is sweet and delicious to taste). All of this are found in a pod, also called a cacao pod, which is about 15 to 30 cm long and about 10 cm wide. The cacao pods takes about 5 to 6 months to be ready and ripened and hence are harvested around the world twice.

At the start of my morning routine I like to sit outside and just enjoy my morning breeze (if you can call it that way in Townsville). Almost every morning, there is this special calling from an unknown bird so I decided to investigate the specimen that created that sound. I noticed that the bird made three distinct noises. One that is a deep continuous “coo coo coo” that has been easily documented but the others are really strange to describe. It is like a slow pace high pitch sweesh and the other one is a moderate pace group of sounds that I cannot even describe.