Australian Journal of General Practice最新文献_第3页

AJGP reviewers 2024.

IF 1.6 4区医学

Australian Journal of General Practice Pub Date : 2024-12-01

引用次数: 0

Reflections on leadership for diverse practice. 对多元化实践中领导力的思考。

IF 1.6 4区医学

Australian Journal of General Practice Pub Date : 2024-12-01 DOI: 10.31128/AJGP-11-23-7023

Deborah Saltman

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A clinical approach to chronic respiratory disorders in Aboriginal and Torres Strait Islander Australians in primary care. 土著和托雷斯海峡岛民在初级保健中慢性呼吸系统疾病的临床方法。

IF 1.6 4区医学

Australian Journal of General Practice Pub Date : 2024-12-01 DOI: 10.31128/AJGP-02-24-7136

Subash S Heraganahally, Timothy Howarth, Winnie Chen

{"title":"A clinical approach to chronic respiratory disorders in Aboriginal and Torres Strait Islander Australians in primary care.","authors":"Subash S Heraganahally, Timothy Howarth, Winnie Chen","doi":"10.31128/AJGP-02-24-7136","DOIUrl":"10.31128/AJGP-02-24-7136","url":null,"abstract":"Background: Chronic respiratory disorders in the adult Aboriginal and Torres Strait Islander population are common, but there is a sparsity of literature detailing an approach to clinical management.Objective: This paper describes a clinical approach to chronic respiratory disorders for clinicians working with Aboriginal and Torres Strait Islander people, particularly in the remote Australian context.Discussion: There are significant differences in the way chronic respiratory diseases manifest in Aboriginal and Torres Strait Islander people compared with non-Indigenous Australians. Chronic obstructive pulmonary disease (COPD), bronchiectasis and asthma often overlap in clinical features, and can be present concurrently. Restrictive impairment on spirometry is common. The presence of bronchodilator response might indicate asthma, but can also be observed in patients with asthma/COPD/bronchiectasis overlap. Because the management of each of these conditions differs, accurate diagnosis and disease severity classification are important, particularly in the prescribing of guideline-recommended inhaled pharmacotherapy.","PeriodicalId":54241,"journal":{"name":"Australian Journal of General Practice","volume":"53 12 Suppl","pages":"S3-S9"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856082","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

Adult-onset dysphagia. 成人吞咽困难。

IF 1.6 4区医学

Australian Journal of General Practice Pub Date : 2024-12-01 DOI: 10.31128/AJGP-08-23-6928

Fred Chuang, Rohan Arasu, Gavin Quail, Stephen Johnston

{"title":"Adult-onset dysphagia.","authors":"Fred Chuang, Rohan Arasu, Gavin Quail, Stephen Johnston","doi":"10.31128/AJGP-08-23-6928","DOIUrl":"https://doi.org/10.31128/AJGP-08-23-6928","url":null,"abstract":"Background: Dysphagia, characterised by a difficulty in swallowing, stems from various causes and is frequently encountered in general practice. The rise in dysphagia in Australia's ageing population necessitates proper management to prevent complications. Recognising and managing dysphagia improves outcomes and quality of life, and reduces secondary complications.Objective: This article assists physicians through the work-up and management of dysphagia.Discussion: Dysphagia, resulting from upper aerodigestive tract disruptions, can be categorised anatomically (oropharyngeal, oesophageal) or by pathophysiology (motility, obstructive). It imposes a substantial community disease burden with high morbidity and mortality rates. Dysphagia might lead to aspiration, malnutrition and poor mental health. A holistic approach involving primary and tertiary specialists, allied health, family and carers is vital. Depending on the aetiology, dysphagia is often treated conservatively in the community; however, complex cases often require a multifaceted approach and integration of multiple specialties.","PeriodicalId":54241,"journal":{"name":"Australian Journal of General Practice","volume":"53 12 Suppl","pages":"S33-S40"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856142","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

Chemical eye injury in remote and urgent care clinic settings. 偏远和紧急护理诊所环境中的化学眼损伤。

IF 1.6 4区医学

Australian Journal of General Practice Pub Date : 2024-12-01 DOI: 10.31128/AJGP-10-23-6998

Lawrence Kwok, Andrew Burbidge

{"title":"Chemical eye injury in remote and urgent care clinic settings.","authors":"Lawrence Kwok, Andrew Burbidge","doi":"10.31128/AJGP-10-23-6998","DOIUrl":"https://doi.org/10.31128/AJGP-10-23-6998","url":null,"abstract":"Background: Chemical eye injuries are potentially sight-threatening injuries, representing 10-22% of all ocular trauma presentations. Prompt assessment and management of chemical eye injuries in general practice and urgent care clinic settings can prevent patients from losing vision.Objective: This article presents a clinically useful guide for general practitioners to support the primary management of chemical-related eye injuries, particularly in rural and regional settings. This article will first discuss the variety of chemical eye irritants found in domestic and commercial settings. It will then describe the steps for assessment of chemical-related eye injuries, methods for irrigation and post-irrigation management.Discussion: Among chemical eye injuries occurring in rural areas, cleaning agents are the most common cause, followed by injuries from personal products, industrial agents, pesticides and herbicides, and petroleum-based products. General practitioners should conduct an initial assessment and instigate immediate management of chemical eye injuries. Advice about the pH level of substances can be obtained from the Poisons Information Centre. Chemical eye injuries coinciding with an epithelial defect or decreased vision should be reviewed by an ophthalmologist within 24 hours of the initial injury.","PeriodicalId":54241,"journal":{"name":"Australian Journal of General Practice","volume":"53 12 Suppl","pages":"S45-S48"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856270","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

Median arcuate ligament syndrome: When to consider the diagnosis and management options. 正中弓状韧带综合征：何时考虑诊断和治疗方案。

IF 1.6 4区医学

Australian Journal of General Practice Pub Date : 2024-12-01 DOI: 10.31128/AJGP-11-23-7045

Vidushi Lal, Lucy Guazzo

{"title":"Median arcuate ligament syndrome: When to consider the diagnosis and management options.","authors":"Vidushi Lal, Lucy Guazzo","doi":"10.31128/AJGP-11-23-7045","DOIUrl":"10.31128/AJGP-11-23-7045","url":null,"abstract":"Background: Median arcuate ligament syndrome (MALS) occurs due to extrinsic compression of the coeliac plexus, leading to postprandial and exercise-induced epigastric pain, nausea, vomiting, food fear and weight loss. Diagnosis can be challenging as up to 25% of the population have radiological compression. However, only 1% of the population have corresponding symptoms. The duration between the onset of symptoms and diagnosis of MALS can extend up to years. Primary care physicians are commonly the first people to encounter patients with MALS and play a vital role in its assessment, diagnosis and management and the coordination of subspecialty care.Objective: The aim of this article is to provide general practitioners with a review of the current literature, summarise a diagnostic pathway and propose a treatment algorithm for MALS.Discussion: MALS is a rare cause of debilitating abdominal pain with no single 'rule in test'. It often affects young patients and leads to significant morbidity and poor quality of life. Increased awareness of MALS in the primary care setting allows for earlier consideration and investigation as part of the diagnostic work-up for patients with symptoms of abdominal pain not attributable to more common conditions.","PeriodicalId":54241,"journal":{"name":"Australian Journal of General Practice","volume":"53 12 Suppl","pages":"S28-S32"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856573","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

Burnout and retention of general practice supervisors: Prevalence, risk factors and self-care. 全科医生主管的职业倦怠和留任：患病率、风险因素和自我保健。

IF 1.6 4区医学

Australian Journal of General Practice Pub Date : 2024-12-01 DOI: 10.31128/AJGP-11-23-7011

Samia R Toukhsati, Rebecca Kippen, Carla Taylor

{"title":"Burnout and retention of general practice supervisors: Prevalence, risk factors and self-care.","authors":"Samia R Toukhsati, Rebecca Kippen, Carla Taylor","doi":"10.31128/AJGP-11-23-7011","DOIUrl":"10.31128/AJGP-11-23-7011","url":null,"abstract":"Background and objectives: Burnout is common in primary care doctors. The aim of this study was to explore burnout, self-care and retention in general practice supervision in Australia.Method: The sample comprised 267 general practice supervisors from all Australian states and territories. Respondents completed an anonymous online survey.Results: Respondents reported high levels of disengagement (n=189; 71%) and exhaustion (n=212; 79%). Factors associated with burnout included being younger; working while unwell; holding the belief that workplace support for self-care was inadequate; and lower daily balance and/or professional development self-care. Exhaustion was negatively associated with general practice supervisor retention via its negative effect on self-care (β=-0.379; 95% CI: -0.777 to -0.050).Discussion: Burnout is common in general practice supervisors and is associated with attrition, possibly via a negative effect on self-care. Greater investment in workplace initiatives to address burnout and sector-wide strategies to reduce workforce shortages are needed.","PeriodicalId":54241,"journal":{"name":"Australian Journal of General Practice","volume":"53 12 Suppl","pages":"S85-S90"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856184","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

Understanding general practice funding models in Australia and beyond. 了解澳大利亚和其他地区的全科医疗资助模式。

IF 1.6 4区医学

Australian Journal of General Practice Pub Date : 2024-12-01 DOI: 10.31128/AJGP-01-24-7132

Winnie Chen, Kees van Gool, Michael Wright

引用次数: 0

Evaluating the role of weight loss in symptomatic knee osteoarthritis: An audit of Osteoarthritis Healthy Weight For Life's database. 评估体重减轻在症状性膝骨关节炎中的作用：对骨关节炎健康体重终生数据库的审计。

IF 1.6 4区医学

Australian Journal of General Practice Pub Date : 2024-12-01 DOI: 10.31128/AJGP-09-23-6978

Elysse McIlwain, Ben Wilcox, Ryan Gallagher, Luke Lawler, David Dewar

{"title":"Evaluating the role of weight loss in symptomatic knee osteoarthritis: An audit of Osteoarthritis Healthy Weight For Life's database.","authors":"Elysse McIlwain, Ben Wilcox, Ryan Gallagher, Luke Lawler, David Dewar","doi":"10.31128/AJGP-09-23-6978","DOIUrl":"https://doi.org/10.31128/AJGP-09-23-6978","url":null,"abstract":"Background and objectives: Obesity contributes to the onset and progression of osteoarthritis. This study assesses the influence of baseline body mass index (BMI) and baseline knee pain on improvements observed in patients undertaking a community-based weight loss program for knee osteoarthritis.Method: This study is a retrospective analysis of data from 9004 patients who took part in the Osteoarthritis Healthy Weight For Life program between January 2014 and July 2022.Results: The greater the weight loss achieved, the greater the improvement in knee pain and function, with baseline weight having no effect on the magnitude of the outcome. All patients with a starting Knee Injury and Osteoarthritis Outcome Score of <75 experienced significant improvement in their symptoms. Patients with more severe starting pain saw greater improvements.Discussion: Baseline BMI has no effect on the amount of weight loss required to produce a meaningful improvement in osteoarthritis symptoms. Patients with more severe baseline knee pain see more improvement than those with milder symptoms for the same weight loss.","PeriodicalId":54241,"journal":{"name":"Australian Journal of General Practice","volume":"53 12","pages":"945-950"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774699","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

To do or not to do: Teaching the skill of deciding what to do in the face of uncertainty. 做或不做：教授在面对不确定性时决定做什么的技能。

IF 1.6 4区医学

Australian Journal of General Practice Pub Date : 2024-12-01 DOI: 10.31128/AJGP-08-23-6949

Gerard Ingham

{"title":"To do or not to do: Teaching the skill of deciding what to do in the face of uncertainty.","authors":"Gerard Ingham","doi":"10.31128/AJGP-08-23-6949","DOIUrl":"https://doi.org/10.31128/AJGP-08-23-6949","url":null,"abstract":"Background: The management of uncertainty is a core general practice skill best learnt in clinical practice.Objective: This article outlines strategies a general practice supervisor can implement to help registrars acquire the skills of managing and coping with uncertainty.Discussion: The medical education literature recommends supervisors being explicit about the different paradigm operating in primary care and normalising the existence and tolerance of uncertainty. Fundamental consultation skills used in the management of uncertainty should be demonstrated. These include shared decision making, safety netting and arranging follow-up. During teaching sessions, problem cases can be explored using Murtagh's diagnostic model to develop clinical reasoning and avoid missing important diagnoses. This paper introduces a model to explore uncertainty by considering management options, easily remembered as the '3Rs': review; refer; and Rx (treat). This model complements the diagnostic model and reflects that a general practitioner must still decide what to do when a diagnosis cannot be made.","PeriodicalId":54241,"journal":{"name":"Australian Journal of General Practice","volume":"53 12","pages":"900-903"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774784","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