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Newsletter Number 5 - August 1999

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NEWZATS HOSTED AN EVENING FOR AMANZ - 26 APRIL

The New Zealand Association of Teachers of Singing -Wellington Branch - invited international guest speaker, Alison Bagnall, to discuss 'Damage to the Voice', a subject very close to all of us, and in particular to actors and singers.

Damage to the voice can occur through misuse, or through neck and head injuries following an accident. Whatever the cause, our lives and personalities are seriously effected if the voice is in some way impaired.

At the evening on April 26, the large audience was given considerable information about how to maintain the healthy use of the voice in everyday life, as well as some controversial and expansive detail for teachers involved with speech and singing.

Alison Bagnall moved from the position of Chief Speech Pathologist at the Royal Adelaide Hospital into private practice for voice professionals, and over the past twenty years has developed her own unique approach to the ways of caring for the voice. She presents her work internationally. Already widely recognised in the area of voice and cleft palate work, she trained with Jo Estill, developing mastery of Jo's innovative, research-based physiological/acoustic model for the understanding of the singing voice. She extended this for the needs of both singers and speakers with therapeutic approaches, greater task analysis and Feldenkrais-style body awareness - and called the result VOICECRAFT. Alison's commitment is to the total well-being of the participant as Voicecraft focuses not only on the mechanics but also the psychodynamics of skilful use of the voice.

At our evening on April 26, Alison involved her audience with various vocal exercises and gymnastics (!) to help us 'feel' the safe and unsafe ways of voice use. She demonstrated many of her Voicecraft techniques with audio/visual aids. The slides and videos clearly illustrated her topic of discussion. In particular her own video 'Yell Well', showing children in a school playground, screaming and laughing happily - and safely - as a starting point to her programme of exercises with a young child suffering from severe voice damage, was a particular highlight of her talk.

(Any further enquiries regarding Alison Bagnall's visit can be made to Loretta Lander through AMANZ)

ELIZABETH ANDREWS - LECTURE 24 MAY

Over 50 people attended a public lecture at Victoria University jointly

organised by AMANZ and Sports Medicine NZ. Elizabeth Andrews, a specialist chiropractor for musicians from the UK spoke on "Healthy Practice for Musicians", which is also the title of her recently published book (see below).

Elizabeth Andrews' long career as a professional musician ensured her presentation was well grounded in the practicalities of a musician's work. Her main focus was on self-help, with demonstrations of "Touch for Health" (applied kinesiology), adapting chairs for better comfort, postural adjustments and other techniques musicians can use to look after themselves.

The audience included music teachers & students, and a range of health practitioners as well as musicians, and Elizabeth touched on issues like the relationship between a musician and her GP and the relevance of sports medicine to musicians. Elizabeth was probably given too much ground to cover in two hours, but there were plenty of questions asked during the lecture and over a glass of wine afterwards.

Workshops and individual lessons were also given by Elizabeth Andrews to students at Victoria University, Wellington Polytechnic and Otago University, and to the musicians of the New Zealand Symphony Orchestra.

AMANZ is grateful to Sports Medicine NZ for their help with the lecture and to the NZSO for their help with the arrangements for Elizabeth Andrews' visit.

For further information on "Healthy Practice for Musicians" (Rhinegold Publishing, UK, 1998, 432 pp, ISBN 0 946890 73 0) contact Elizabeth Andrews by e-mail on playwell@dircon.co.uk , or look up her website at http://www.impulse-music.co.uk /healthypractice/

AMANZ also has some brochures - see contact details elsewhere in this newsletter. If you're interested in the possibility of being part of a bulk order of the book, contact Robert Ibell on 04-385 2557, or e-mail: dawbell@actrix.gen.nz

Robert Ibell
AMANZ

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VOICE MASSAGE

Mikki Michelsson, trained in classic Finnish Massage with a post-graduate diploma in Voice Massage, will be working in New Zealand until mid-September. Mikki runs a clinic in Helsinki where he specialises in the treatment of necks, shoulders, arms and laryngeal massage. This includes the retraining of people with vocal and speech problems through massage and associated preventative therapy for those who use voice in their employment, eg, teachers, radio broadcasters, singers, actors, etc.

Voice massage was developed in Finland by Leena Koskinen, a qualified and state registered lymphotherapist-masseuse, who worked with specialists during the late 1980's to early 1990's.

The object of voice massage is to eliminate tension in the muscle groups involved in the production of the voice. It addresses both the specific muscle groups directly involved, and those muscles which indirectly support the voice, eg, the respiratory area; muscles in the back of the neck, throat and shoulders. Treatment can be given for distortions and disturbances, along with elimination of tension for those suffering from an uneven bite (malocclusion).

Mikki can be contacted on: phone (03) 379 9188 or fax (03) 379 9639

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THE ARTS ACCESS COLUMN

Arts Access Aotearoa works to advocate access to the arts for people with limited access to them. Based in Wellington, the Trust works on a national basis in the sectors of health, justice, older adults, disability and refugees and migrants.

International Year of Older Persons 1999 (IYOP) is a focus this year for Arts Access Aotearoa. Aidan McLean, IYOP Co-ordinator, is encouraging the development of many arts projects for older adults. His work currently includes promoting the designing and making of wind banners by rest homes, in conjunction with local schools. These projects highlight the intergenerational theme of IYOP.

John Dodds and Hannah Dowsett, two professional musicians, received a funding grant from the Wellington City Council Creative Communities Scheme. They are performing a series of concerts at rest homes. Their performances are a mix of playing to a group and spending time with individuals who are unable to attend the group concerts.

The Age of Opportunity festival will be held in the Wellington Town Hall, 1st October 1999. This major celebration of IYOP is being co-ordinated by Aidan McLean, Neil Palmer, Arts Advisor WCC and an energetic team involved with older adults and the arts. Events will include; a visual arts exhibition, musical performances, old time cinema, an intergenerational choir, a vintage car display, static displays and much more! Everyone is welcome to attend this free day.

Another Arts Access Aotearoa IYOP project is the development of a publication highlighting older adults and the arts. Currently being written by Aidan, it will feature art projects from around New Zealand and encourage rest homes and organisations to develop arts initiatives and celebrate the arts of older adults. More information on this will be included in future columns.

For further information on Arts Access Aotearoa: PO Box 9828, Wellington, telephone 04-384-1113, fax 04-384-1119, e-mail artsaccess@xtra.co.nz or visit our website: http://www.artsaccess.org.nz

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ACC AND WORK INJURIES FROM JULY 1, 1999

From July 1, 1999, changes to ACC legislation meant that the system for receiving ACC benefits has changed.

If you are employed, your employer now has had to nominate a private insurance company to cover treatment, rehabilitation and off work expenses. ACC no longer covers work-related injuries. Your employer is obliged to inform you of your work insurance company and the procedures to follow should you sustain a work-related injury. For many dancers and musicians where many injuries are 'gradual process' or OOS-type injuries, the criteria defining these conditions are still the same.

If you are self-employed, the legislation has given you the option to choose your own work insurer or remain with ACC.

If you are not employed, ACC will still cover you for your injuries. ACC cover is still available for all non-work related injuries, for example:

ACCIDENTS

* at home
* playing sport
* during other recreational activities
* while using New Zealand roads

A PATIENT who suffers an injury as a result of medical misadventure, except if the treatment was for a work-related injury

A PATIENT with a claim for mental injury resulting from sexual abuse

The other major change is that you no longer need to see a doctor initially for a referral to another treatment provider, such as a physiotherapist. Therefore ACC and the Work Insurers have a list of Registered Treatment Providers who can now see you, treat and claim directly if the treatment provided is within their 'normal scope of practice'. These include acupuncturists, chiropractors, counsellor/psychologists, osteopaths, physios, podiatrists, lab technicians, etc. Not homeopaths, herbalists or other alternative practitioners, nor body conditioning therapists.

However, a doctor is the only health professional who can assess work incapacity and give you time off work, but cannot back-date this.

As you can imagine, the changes have been huge for employers and health professionals. With this has come very detailed and cumbersome forms to fill out, with ACC/Insurance claims filed everywhere! The Medical Doctors have voiced grave concerns about a number of these changes, particularly the increased paper work, bureaucracy and time-wasting form filling, budget blow-outs and general confusion. You will find many doctors have increased their ACC/accident consultation fees to recoup for the extra time and work which has been enforced upon them.

Tips for ACC/work-related injuries:

  1. Determine clearly whether yours is a work-related or non-work-related injury.
  2. Know who is your work's Insurance Company.
  3. If you have an injury at work, record it in the 'incident book'.
  4. While waiting for your consultation with a treatment provider, please ask for the accident form, either ACC's ACC45 form or the Work AITC form. Good luck with the form filling!
  5. Hold on to your copy of these forms and take them everywhere you seek treatment.
  6. If you need time off work, see your doctor; he/she cannot fill it retrospectively!
  7. Always reassess your progress with a treatment provider; you should be making significant progress after 3-5 treatments. If not, you may need another independent opinion!

Dr Roz Wilson Sports and General Practitioner
Rotorua

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ACUTE LOW BACK PAIN MANAGEMENT

ACC has produced a brochure on acute low back pain management and AMANZ has a number of copies. The brochure details what to expect when you go to a treatment provider, how to help yourself, different treatments and blueprints for Action Plans and Return to Work Plans. Please get in touch with Dawn Sanders if you would like a copy.

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GLANDULAR FEVER

(Also known as Infectious Pfeiffer's Disease or Mononucleosis)

An article specially written for AMANZ by Dr Keith Humphries, MBCHB, FRCNZCGP

This common disorder is mainly that of the adolescent and young adults. It is rarely diagnosed under the age of five years or over 45. The young under five probably have mild sub-clinical attacks that are not severe and usually not diagnosed.

Aetiology

Probably mainly due to the Herpes Simplex Virus (cold sore type virus) or Epstein -Barr (usually known as E-B) Virus. Glandular fever type syndromes of a similar clinical presentation can also be attributed to Cyto-Megalic Inclusion Virus (CMV) or from the protozoan Toxoplasma gondii (Toxoplasmosis). CMV usually appears in the older age group and is sometimes associated with other health problems in the immune-compromised, e.g, AIDS or Transplant Organ Patients, or those with cancer or receiving cancer Chemotherapy Treatments. Glandualar fever is usually used as a label in the British type countries; Infectious Mononucleosis is the name used in the USA.

Incubation

Various times given by various authors, eg 5 - 10 days to 4 - 8 weeks

Infectivity

Usually described as mild; usually from spread of saliva, hence the nick-name the Kissing Disease. Aerosol affect (sneezing and coughing) with Fomites (faeces and urine) spread not thought to be a big factor, so that isolation is not usually recommended. Some of the early work in the 1970's was done on Yale Medical Students. In an epidemic about 70% carried detectable virus antibodies but less than 10% of them had signs or symptoms.

Signs and Symptoms

Disorder of protean manifestation - tiredness, malaise and generalised aches and pains in muscles and headache. Fever; swollen neck glands (cervical lymphaderopathy) and a sore throat (pharyngitis) are usually the triad of symptoms to raise the suspicion for diagnosis. Mild nausea, anorexed and upper abdominal pain with liver and spleen tenderness are common. Mild jaundice (glandular fever hepatitis) is not uncommon. A mild rash on the palate at the junction of the hard and soft palate often precedes the pharyngitis or tonsillitis. Quite often an exudative white, necrotic marked tonsillitis is seen - but beware that this can in Leukaemia, so that further blood test investigations should be mandatory. Liver and spleen tenderness and enlargement is sometimes found, sometimes quite marked. The glands in the neck (deep cervical chain) are usually small and multiple and unlike the more discrete glands of Hodgkin's Disease, Lymphomas and Tuberculosis. Glands are sometimes felt in other regional areas: ascillae (arm-pits) and groin. A measles-like rash can be found in 5% of cases. Ampicillin (Penbritin), a penicillin-type antibiotic, if administered can cause a rash in 90%-100% of cases.

Laboratory Tests

Usually a full blood count (FBC) and liver function tests (LFS) should be made to support the diagnosis. With the clinical picture and a WBC (white blood count) showing abnormal mononucleosis cells (lymphocytes) of 10%-80% will give the chief clue but other disorders, such as CMV, Toxoplasmosis and even Tuberculosis can give a similar picture. There is usually a slight rise in the total WBC (10,000 to 20,000 per m.m3). The more specific tests, eg, the now somewhat old-fashioned Paul-Burrell Test (two American physicians) can be done. This is a "hit and miss" test and often has to be repeated to get a positive test, ie, you can still have glandular fever and have a negative P-B test. The more specific EBV antibody tests are popular but expensive. They are sometimes misinterpreted. Acute infection requires a positive 1g M test, however a positive 1g on the EBV test may persist lifelong and merely indicates present or past exposure. The severity of the generalised illness can to some extent be supported by a more severe abnormality in the live function tests, so that hight enzyme tests usually indicate a more severe disease. Thrombocytopaenia (low platelet count) is sometimes found.

Course and Prognosis

Most cases have symptoms for 3 - 4 weeks. Malaise particularly, with difficulty in concentrating, eg, study for exams, may last 3 - 4 months. Improvement is usually seen by disappearance of swollen glands, sore throat declines and resumption to normal of the FBC and LFS. Some advocates of ME (myalgic encephalopathy) or Chronic Fatigue Syndrome latch on to the diagnosis of long term glandular fever as the cause. Glandular fever is usually a benign self-limiting disorder, however rare fatal disorders have been recorded, particularly from the rupture of an enlarged, friable spleen.

Treatment

Mainly symptomatic. Rest and good sensible food is the chief advice given. Active physical exercise and sport often delays recovery and of course rupture of a friable spleen is possible, particularly in contact sports. Bed rest and adequate fluids in acute cases. The usual recommendation is for little or no alcohol, particularly with abnormal liver function tests. Some doctors use steroids (Prednisone, etc) with severe symptoms, eg, very bad throat symptoms or liver function tests.

Common Fallacies

It is not usually thought to "spread through the office" or to be spread by air conditioning or to be highly infectious. Seasonal epidemics, however, do seem to occur. Many people have resistance and it is unusual to spread from husband to wife or "around the flat" Common sense and optimism should be a good recommendation for this common interesting disorder.

PS: in AIDS, glandular fever can be a presenting symptom.

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FROM DANZ:

Healthier Dancer Series

As part of our on-going DANZ day series, DANZ will be hosting a Healthier Dancer Series. Following successful workshops in Christchurch and Dunedin earlier this year, we are set to continue the series in Auckland and Wellington. These days will provide a valuable resource to a wide cross-section of the dance community from dance teachers, professional dancers and dance students, to interested members of the public.

Issues covered will include:

  • Supplementary Training - Aerobic and Strength
  • Common Dance Injuries and their management
  • Health issues facing dancers such as osteoporosis and iron deficiency

Workshops will be led by Susan Simpson, a graduate of the New Zealand School of Dance and Otago Polytechnic. Since gaining her graduate diploma in Physiotherapy she has worked with a variety of clients including the prestigious Royal Ballet Company and Rambert Dance Company, both in London. Susan currently works at the New Zealand School of Dance and Wakefield Physiotherapy Clinic in Wellington.

Dates for the workshops are:

Christchurch Sunday 26 September
Dunedin Monday 27 September

Dates for the Auckland and Wellington workshops are still to be confirmed.

For details contact danz (04) 382 8463

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FOOTNOTE DANCE COMPANY

Footnote Dance Company has had an extremely busy year with tours to Marlborough, Waikato and Auckland already completed and tours to Waikato again, Hawkes Bay, Southland, Dunedin and Christchurch coming up. Our time in schools has been very extensive with both performances of repertoire, workshops and residencies forming a huge workload. Our New Zealand works this year are being presented in public seasons of Over the Moon. Included on the programme are:

  • pheromone
    Shona McCullagh
  • From Zero to Nothing
    Chris Jannides
  • Two axe handles across
    Katherine Waldner
  • Over the Moon
    Deirdre Tarrant
  • One more than Two
    Catherine Gardner
  • Matter Over Mind
    Sally Stopforth

and a new work by company dancer Melanie Turner, called Spanner

The dancers Jane Duncan, Melanie Turner, Moss Asher-Patterson, Stu Armstrong and apprentice Nicole Gerber form a strong company with excellent teaching skills.

Over the Moon performances still to come near you?

Dunedin
8.00pm Saturday 21 August 1999
Maurice Joel Auditorium,
Otago Boys' High School

Christchurch
8.00pm Saturday 4 September 1999
4.00pm Sunday 5 September 1999
Southern Ballet Theatre

Wellington
Saturday 18 September 1999
4.00pm Sunday 19 September 1999
Memorial Theatre, Victoria University

Company Director Deirdre Tarrant has been looking at ways of maintaining professional strength and flexibility, combining technique class with other methods. Kilda Northcott and Susie Simpson sessions have been added when the company is in its homebased Wellington studio.

Enquiries or tickets for Footnote please contact Rowena Snell, Administration Manager, on phone: (04) 384 7285 or fax: (04) 801 5010

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AMANZ NEWS

Two additions within the ranks! Sharon Callaghan, our intrepid secretary, gave birth earlier this year to a girl, Mirren. Congratulations also go out to Dr Ruth Highet, (also on the Executive of AMANZ), whose baby son Joshua was born in May. And belated congratulations to our esteemed patron, Jon Trimmer for his knighthood!

On a more sombre note, we send condolensces to Ann Rowse for the passing of her husband Ken Sudell on July 18th.

AMANZ MEETINGS

Please note: that our next meeting has been changed to Thursday August 19th, 7.30pm, Wakefield Medifit. This will be our last "business" meeting until the Christmas Party/meeting, December 15th. Our next (and last for 1999) seminar is:

Monday October 18th, 7.30pm. This is an Alternative Therapies evening with presentations from practitioners including Alison Kyle (Pilates) and Elke Dunlop (Feldenkrais). Please dress in loose, comfortable clothing for this interesting, exciting evening. Venue:

Wellington Conservatorium of Music, (Massey University) Room 1D16 in block 1 through Entrance C off Wallace Street.

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Advertising in the AMANZ Newsletters

N.B. Our Affiliate members are entitled to one free advertisement of a seminar in our Newsletter.The database sheet to be sent with the next Newsletter will also promote our members' skills and services. To sign up, go to the JOIN AMANZ form.

Newsletters for 1999 will be published on 18 May, 18 August and 18 November. Deadlines for copy: 30 April, 31 July, 31 October 1999

All types of advertising are welcome, members, non-members practitioners, performers - anyone with anything to advertise!

This newsletter has a current circulation of 150+ (and increasing ) and is, as a serial registered with the National Library, is also registered in Paris and available to publishers, book suppliers and libraries globally. We have affiliate organisations in the United States and Great Britain and now have our own web site which contains the current newsletter so the potential for coverage is enormous!

Schedule of fees:
$30 for a quarter page
$50 for a half page*
$100 for a whole page*
Sign up for a year (four issues) and receive a 15% discount.
*Half and whole page advertisements can appear on left hand pages only in the print newsletter.

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Join AMANZ
AMANZ offers benefits to members, including discounted admission to some related events where possible, and as time goes on we hope to offer benefits in other areas too (eg. discounted insurance premiums etc). To join AMANZ complete our form

Contact AMANZ:
P O Box 17 215, Karori,
Wellington, New Zealand
Ph: 64 4 476 8369 Fax: 64 4 476 8754
E-mail: action-sanders@xtra.co.nz
Mobile 025 283 6016

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Disclaimer: The opinions and statements of individuals in this newsletter do not necessarily reflect views held by AMANZ. We would, however, be pleased to receive your comments/complaints should you wish to contact us.
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