Australian Journal of General Practice最新文献_第10页

The impact of preparation time on accreditation performance within Australian general practices. 准备时间对澳大利亚全科医生评审成绩的影响。

IF 1.6 4区医学

Australian Journal of General Practice Pub Date : 2024-11-01 DOI: 10.31128/AJGP-12-23-7058

David T McNaughton, Paul Mara, Michael P Jones

{"title":"The impact of preparation time on accreditation performance within Australian general practices.","authors":"David T McNaughton, Paul Mara, Michael P Jones","doi":"10.31128/AJGP-12-23-7058","DOIUrl":"10.31128/AJGP-12-23-7058","url":null,"abstract":"Background and objectives: Australian general practices are highly involved with accreditation programs; however, there is evidence to suggest variability in their levels of performance. The aim of the current study was to determine the association with between several metrics of preparation with accreditation performance outcomes.Method: Several metrics were synthesised that measured preparation time to general practice accreditation. Performance outcomes were: (1) conformity to 124 indicators of the standards; (2) time to remediate indicator non-conformities; and (3) level of assistance required.Results: A greater number of months between registration with the accrediting agency and practice accreditation expiry date was associated with higher indicator conformity at the site visit (OR=1.04, P=0.001), as well as less time (β=-0.02, P=0.002) and less assistance (β=-0.66, P=0.02) to remediate non-conformant indicators post site visit.Discussion: Adequate preparation time for several components within the accreditation framework for general practices were associated with small-to-moderate improvements in key performance outcomes.","PeriodicalId":54241,"journal":{"name":"Australian Journal of General Practice","volume":"53 11 Suppl","pages":"S102-S106"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Skin health of urban-living Aboriginal children attending a primary care Aboriginal Community Controlled Health Organisation clinic. 在原住民社区控制健康组织初级保健诊所就诊的城市原住民儿童的皮肤健康。

IF 1.6 4区医学

Australian Journal of General Practice Pub Date : 2024-11-01 DOI: 10.31128/AJGP-03-24-7177

Bernadette M Ricciardo, Heather-Lynn Kessaris, Uncle Noel Nannup, Aunty Dale Tilbrook, Richelle Douglas, Daniel Hunt, Kim Isaacs, Jessamy Stirling, Jacinta Walton, Carol Michie, Brad Farrant, Eloise Delaney, S Prasad Kumarasinghe, Jonathan R Carapetis, Asha C Bowen

{"title":"Skin health of urban-living Aboriginal children attending a primary care Aboriginal Community Controlled Health Organisation clinic.","authors":"Bernadette M Ricciardo, Heather-Lynn Kessaris, Uncle Noel Nannup, Aunty Dale Tilbrook, Richelle Douglas, Daniel Hunt, Kim Isaacs, Jessamy Stirling, Jacinta Walton, Carol Michie, Brad Farrant, Eloise Delaney, S Prasad Kumarasinghe, Jonathan R Carapetis, Asha C Bowen","doi":"10.31128/AJGP-03-24-7177","DOIUrl":"10.31128/AJGP-03-24-7177","url":null,"abstract":"Background and objectives: Despite increasing urbanisation, little is known about skin health for urban-living Aboriginal children and young people (CYP, aged <18 years). This study aimed to investigate the primary care burden and clinical characteristics of skin conditions in this cohort.Method: A one-year retrospective cohort study of urban-living Aboriginal CYP presenting for general practitioner (GP) consultation at an Aboriginal Community Controlled Health Organisation (ACCHO) was conducted.Results: At least one dermatological diagnosis was made in 27% (253/939) of GP face-to-face consultations for the 585 urban-living Aboriginal CYP included. Infections and dermatitis accounted for 54% (152/284) and 18% (50/284) of all dermatological diagnoses, respectively. Bacterial skin infection (BSI) cumulative incidence was 13% (74/585; 95% CI 10-16%), with recurrent BSI affecting <1% (5/585; 95% CI 0.3-2%) and hospitalisation required in 1% (1/82; 95% CI 0.06-7%) of incident BSI cases.Discussion: We present a culturally secure, multidisciplinary skin health assessment model within an urban ACCHO, where dermatological conditions account for a significant proportion of GP workload.","PeriodicalId":54241,"journal":{"name":"Australian Journal of General Practice","volume":"53 11 Suppl","pages":"S115-S122"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Approach to allergic rhinitis in the primary care setting. 过敏性鼻炎的初级治疗方法。

IF 1.6 4区医学

Australian Journal of General Practice Pub Date : 2024-11-01 DOI: 10.31128/AJGP-07-23-6890

Deepika Gunda, Javaria Mustafa, Nicholas Agar, Peter Goss

{"title":"Approach to allergic rhinitis in the primary care setting.","authors":"Deepika Gunda, Javaria Mustafa, Nicholas Agar, Peter Goss","doi":"10.31128/AJGP-07-23-6890","DOIUrl":"10.31128/AJGP-07-23-6890","url":null,"abstract":"Background: Allergic rhinitis (AR) is a common condition that affects 19% of Australians in the community, accounting for approximately 0.6% of all general practitioner presentations. Recent years have seen the emergence of new treatment options, many of which can be delivered in the primary care setting.Objective: The aim of this paper is to provide a contemporary and accessible framework for the clinical assessment, investigation and management of AR in the primary care setting, and to establish appropriate referral criteria for ear, nose and throat and/or allergist/immunologist referral.Discussion: AR is common, and can have a significant effect on both quality of life and function. The diagnosis can be made based on history, examination and appropriate investigations, including serum specific allergen IgE (immunoglobulin E) and/or skin prick testing. Radiological imaging is not part of the work-up for AR. Management consists of four main aspects: allergen avoidance, pharmacotherapy, immunotherapy and procedural interventions. Biological pharmacotherapies are on the horizon.","PeriodicalId":54241,"journal":{"name":"Australian Journal of General Practice","volume":"53 11 Suppl","pages":"S3-S7"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Common incidental urological lesions on computed tomography images: What to do with renal and adrenal computed tomography incidentalomas in a primary care setting. 计算机断层扫描图像上常见的泌尿系统偶发病变：在基层医疗机构如何处理肾脏和肾上腺计算机断层扫描偶发瘤。

IF 1.6 4区医学

Australian Journal of General Practice Pub Date : 2024-11-01 DOI: 10.31128/AJGP-11-23-7014

Jianliang Liu, David Homewood, Nieroshan Rajarubendra, Prem Rashid, Damien Bolton, Nathan Lawrentschuk

{"title":"Common incidental urological lesions on computed tomography images: What to do with renal and adrenal computed tomography incidentalomas in a primary care setting.","authors":"Jianliang Liu, David Homewood, Nieroshan Rajarubendra, Prem Rashid, Damien Bolton, Nathan Lawrentschuk","doi":"10.31128/AJGP-11-23-7014","DOIUrl":"10.31128/AJGP-11-23-7014","url":null,"abstract":"Background: The widespread use of cross-sectional imaging has led to the increased detection of urological incidentalomas. Incidental renal and adrenal masses are the most commonly detected urological incidentalomas and are often encountered by general practitioners.Objective: This review aims to provide an evidence-based approach to managing renal and adrenal masses.Discussion: Renal lesions occur in 14% of computed tomography (CT) scans. Differentials include cysts (benign or malignant), angiomyolipomas, oncocytomas and renal cell carcinomas (RCCs). The Bosniak classification should be used for cystic renal lesions. Active treatment should be considered for RCCs that are >4 cm, symptomatic or rapidly growing. Patients with adrenal lesions should undergo functional work-up. If clinically concerned, screening tests include 1 mg overnight dexamethasone suppression test and plasma or urinary metanephrines. In the presence of hypertension or hypokalaemia, screening for hyperaldosteronism with the plasma aldosterone-to-plasma renin ratio should be considered. Benign adrenal adenomas on CT are <4 cm, homogenous and hypodense (Hounsfield unit <10).","PeriodicalId":54241,"journal":{"name":"Australian Journal of General Practice","volume":"53 11 Suppl","pages":"S47-S52"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Conservative management of patients with end-stage chronic limb-threatening ischaemia in the community. 在社区对终末期慢性危及肢体缺血患者进行保守治疗。

IF 1.6 4区医学

Australian Journal of General Practice Pub Date : 2024-11-01 DOI: 10.31128/AJGP-02-24-7144

Kay Hon, Madeleine Bain, Georgina Minns, Eliza Colley, Robert Fitridge

引用次数: 0

Acceptability and feasibility of a chronic breathlessness diagnostic clinical algorithm in Australian primary care. 澳大利亚基层医疗机构对慢性呼吸困难诊断临床算法的可接受性和可行性。

IF 1.6 4区医学

Australian Journal of General Practice Pub Date : 2024-11-01 DOI: 10.31128/AJGP-11-23-7009

Anthony Paulo Sunjaya, Allison Martin, Clare Arnott, Gian Luca Di Tanna, Chris Gianacas, Guy Marks, Christine Jenkins

{"title":"Acceptability and feasibility of a chronic breathlessness diagnostic clinical algorithm in Australian primary care.","authors":"Anthony Paulo Sunjaya, Allison Martin, Clare Arnott, Gian Luca Di Tanna, Chris Gianacas, Guy Marks, Christine Jenkins","doi":"10.31128/AJGP-11-23-7009","DOIUrl":"10.31128/AJGP-11-23-7009","url":null,"abstract":"Background and objectives: Chronic breathlessness is a frequent diagnostic challenge in primary care. Our aim is to evaluate the feasibility of a stepwise breathlessness diagnostic algorithm for primary care.Method: This mixed-methods study included: (1) a general practitioner (GP) nominal group technique study; (2) focus groups on GPs' views on the algorithm; and (3) analysis of algorithm alignment against patterns of diagnostic referrals and diagnoses of breathlessness presentations (2014-19) from the MedicineInsight primary care electronic health record (EHR) dataset of 1,961,264 patients (405 general practice sites).Results: All the tests in our algorithm, except for echocardiography, were ranked in the top 10 tests used by most GPs for patients presenting with chronic breathlessness. Themes from the focus group include similarity with current practice and test accessibility. Analysis of EHR diagnostic referrals revealed that all tests in the algorithm are regularly utilised and covered the major tests needed for breathlessness diagnoses recorded.Discussion: The results of the three studies support the acceptability and feasibility of the clinical algorithm in primary care.","PeriodicalId":54241,"journal":{"name":"Australian Journal of General Practice","volume":"53 11 Suppl","pages":"S89-S96"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Alcohol consumption in early middle-aged Australian women and access to primary healthcare services: A cross-sectional study. 澳大利亚中年早期妇女的饮酒量与获得初级保健服务的机会：一项横断面研究。

IF 1.6 4区医学

Australian Journal of General Practice Pub Date : 2024-11-01 DOI: 10.31128/AJGP-01-24-7106

Suzannah Bownes, Alexa Seal, Catherine Harding

{"title":"Alcohol consumption in early middle-aged Australian women and access to primary healthcare services: A cross-sectional study.","authors":"Suzannah Bownes, Alexa Seal, Catherine Harding","doi":"10.31128/AJGP-01-24-7106","DOIUrl":"10.31128/AJGP-01-24-7106","url":null,"abstract":"Background and objectives: This study describes the prevalence of risky alcohol consumption in Australian women aged 40-45 years. It explores the relationship between demographic factors and access to and usage of primary healthcare services.Method: Data were obtained from the Australian Longitudinal Study on Women's Health, Survey 8 (1973-78 cohort). Descriptive statistics and univariate logistic regression were used to assess associations of specific factors with risky alcohol consumption.Results: Eleven per cent of respondents reported drinking >10 standard drinks per week. These 'risky alcohol drinkers' attend general practice as frequently as low-risk drinkers despite perceived poorer health. They reported 'rarely or never' seeing the same general practitioner (GP) and described themselves as having 'poor' access to a GP that bulk bills.Discussion: This study provides unique insight into the primary healthcare attendance patterns and health status of early middle-aged Australian women who are 'risky alcohol drinkers'. They do not consistently see the same GP, which might present challenges in identifying them in primary care.","PeriodicalId":54241,"journal":{"name":"Australian Journal of General Practice","volume":"53 11 Suppl","pages":"S97-S101"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Penile dermatology for the general practitioner: A pragmatic approach to diagnosis and management. 全科医生的阴茎皮肤病学：诊断和管理的实用方法。

IF 1.6 4区医学

Australian Journal of General Practice Pub Date : 2024-11-01 DOI: 10.31128/AJGP-01-24-7111

Henry YC Pan, David Homewood, Jonathan S O'Brien, Justin Chee, Nathan Lawrentschuk, Anthony P Hall

{"title":"Penile dermatology for the general practitioner: A pragmatic approach to diagnosis and management.","authors":"Henry YC Pan, David Homewood, Jonathan S O'Brien, Justin Chee, Nathan Lawrentschuk, Anthony P Hall","doi":"10.31128/AJGP-01-24-7111","DOIUrl":"10.31128/AJGP-01-24-7111","url":null,"abstract":"Background: Genital skin conditions are rare and pose a diagnostic challenge due to their diverse pathology. Patient anxiety and referral decisions add complexity for primary caregivers. Demographics and overlapping symptoms complicate diagnosis, causing anxiety for both patients and clinicians. Social stigma and apprehension to seek healthcare might delay treatment. Accurate differentiation between benign and potentially serious conditions is crucial.Objective: We aim to provide clinicians with a clear and concise framework to assist them in risk stratification, treatment decisions and referral pathways for common genital skin conditions.Discussion: Differentiating normal variations is crucial to minimise unnecessary investigations and alleviate patient anxiety. Circumcision status, pigmentation and genetics influence disease presentation. We highlight benign conditions for reassurance. Inflammatory genital lesions might arise from various causes. Biopsies remain essential for accurately diagnosing uncertain cases. Sexually transmitted infections (STIs) should be promptly diagnosed and treated. Neoplastic conditions can evolve rapidly, requiring an urgent specialist referral.","PeriodicalId":54241,"journal":{"name":"Australian Journal of General Practice","volume":"53 11 Suppl","pages":"S37-S46"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clindamycin and bacterial load reduction as prophylaxis for surgical site infection after below-knee flap and graft procedures: A trial protocol. 克林霉素和减少细菌量作为膝下皮瓣和移植手术后手术部位感染的预防措施：试验方案。

IF 1.6 4区医学

Australian Journal of General Practice Pub Date : 2024-11-01 DOI: 10.31128/AJGP-06-23-6881

Clare Heal, Helena Rosengren, Leanne Hall

{"title":"Clindamycin and bacterial load reduction as prophylaxis for surgical site infection after below-knee flap and graft procedures: A trial protocol.","authors":"Clare Heal, Helena Rosengren, Leanne Hall","doi":"10.31128/AJGP-06-23-6881","DOIUrl":"10.31128/AJGP-06-23-6881","url":null,"abstract":"Background and objectives: Management of skin cancer comprises a substantial proportion of general practitioner (GP) workload in Australia. Flap and graft procedures below the knee have an increased risk of infection. Antibiotic resistance is a threat to global health, and any decision about antibiotic prophylaxis must balance adverse outcomes of antibiotic use with patient morbidity. This study will investigate the effectiveness of two interventions to prevent surgical site infection (SSI) after below-knee surgery: (1) 450 mg of clindamycin preoperatively and postoperatively; and (2) preoperative chlorhexidine wash and nasal mupirocin.Method: This prospective randomised controlled trial will be conducted across three skin cancer clinics over nine months, with 155 participants. Consecutive patients presenting for below-knee flap and graft procedures will be eligible to participate. The primary outcome is superficial SSI in the first 30 days following excision. Secondary outcomes include adverse effects (anaphylaxis, skin irritation and foreign body reaction) and patterns of antibiotic resistance.Results: As this is a study protocol paper, there are no results available to present.Discussion: As this is a study protocol paper, there are no results to be discussed.","PeriodicalId":54241,"journal":{"name":"Australian Journal of General Practice","volume":"53 11","pages":"859-863"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical care for women seeking pregnancy after miscarriage. 为流产后怀孕的妇女提供临床护理。

IF 1.6 4区医学

Australian Journal of General Practice Pub Date : 2024-11-01 DOI: 10.31128/AJGP-08-23-6931

Evangeline R Shalou, Alex Polyakov

引用次数: 0