Australian Journal of General Practice最新文献_第4页

A refresher on the primary care and public health management of acute post-streptococcal glomerulonephritis. 急性链球菌感染后肾小球肾炎的初级保健和公共卫生管理综述。

IF 1.6 4区医学

Australian Journal of General Practice Pub Date : 2025-04-01 DOI: 10.31128/AJGP-03-24-7206

Jasraaj Singh, Allison Hempenstall, Melania Scrace, Louise Craig, Malcolm McDonald

{"title":"A refresher on the primary care and public health management of acute post-streptococcal glomerulonephritis.","authors":"Jasraaj Singh, Allison Hempenstall, Melania Scrace, Louise Craig, Malcolm McDonald","doi":"10.31128/AJGP-03-24-7206","DOIUrl":"10.31128/AJGP-03-24-7206","url":null,"abstract":"Background: Acute post-streptococcal glomerulonephritis (APSGN) is an acute autoimmune kidney condition triggered by skin infection or pharyngitis caused by specific strains of Streptococcus pyogenes (Group A streptococcus). In Australia, APSGN is primarily a disease of childhood disadvantage.Objective: The aim of this review is to draw attention to a preventable childhood condition, detailing the clinical presentation, diagnostic pathway and management.Discussion: Children typically present with a nephritic clinical picture: oedema, painless haematuria and hypertension. Diagnostic confirmation requires specific laboratory findings or both clinical and laboratory suggestive evidence. 'Probable' cases only require clinical evidence and 'possible' cases only require suggestive laboratory evidence. Treatment is largely supportive, focusing on the management of hypertension and fluid overload. Suspected and confirmed cases must be notified immediately to regional public health authorities. Outbreaks require a broad-based public health response in accordance with state-based guidelines.","PeriodicalId":54241,"journal":{"name":"Australian Journal of General Practice","volume":"54 4","pages":"213-217"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774794","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 obesity management in Australia: How can we bridge the gap between guidelines and current general practice? 澳大利亚成人肥胖管理：我们如何弥合指南和目前一般做法之间的差距？

IF 1.6 4区医学

Australian Journal of General Practice Pub Date : 2025-04-01 DOI: 10.31128/AJGP-07-23-6903

Bo Bi, Tiana Gurney, Srinivas Kondalsamy Chennakesavan

{"title":"Adult obesity management in Australia: How can we bridge the gap between guidelines and current general practice?","authors":"Bo Bi, Tiana Gurney, Srinivas Kondalsamy Chennakesavan","doi":"10.31128/AJGP-07-23-6903","DOIUrl":"10.31128/AJGP-07-23-6903","url":null,"abstract":"Background and objectives: Obesity is still recognised as a risk factor rather than a chronic disease in Australia. General practitioners (GPs) have reported a lack of confidence and support in the management of obesity. In this study, we explored GPs' current definitions and treatment of obesity and their attitudes towards proposed clinician educational and billing strategies.Method: In this cross-sectional study, an online survey was distributed to GPs across Australia.Results: Of the 189 GPs who completed the survey, 82% defined obesity, with and/or without comorbidities, as a chronic disease. There is a significant gap between current practice and clinical guidelines, particularly in screening and prevention. The overall attitude towards proposed solutions was very positive. Descriptive analysis was used to present the characteristics of the participants. Chi-squared tests or Fisher's exact test were used to evaluate the relationship between categorical variables.Discussion: Australia's outdated definition of obesity likely hinders management and contributes to the observed gap between clinical guidelines and current practice. Clinician education on behaviour change and long-term weight management, funding for more enhanced primary care referrals and Pharmaceutical Benefits Scheme listing of pharmacotherapy for weight loss might be possible solutions.","PeriodicalId":54241,"journal":{"name":"Australian Journal of General Practice","volume":"54 4","pages":"171-178"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774797","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

'They made a hard day feel a little easier': Patients' experiences of an integrated crisis response following recent sexual assault. “他们让艰难的一天变得轻松了一点”：近期性侵犯后患者的综合危机应对经历。

IF 1.6 4区医学

Australian Journal of General Practice Pub Date : 2025-03-01 DOI: 10.31128/AJGP-06-24-7303

Mary Stewart, David J Templeton, Julie Mooney-Somers, Kevin McGeechan, Ellie Freedman, Elisabeth Awad, Tara Hunter, Rita Shackel

{"title":"'They made a hard day feel a little easier': Patients' experiences of an integrated crisis response following recent sexual assault.","authors":"Mary Stewart, David J Templeton, Julie Mooney-Somers, Kevin McGeechan, Ellie Freedman, Elisabeth Awad, Tara Hunter, Rita Shackel","doi":"10.31128/AJGP-06-24-7303","DOIUrl":"10.31128/AJGP-06-24-7303","url":null,"abstract":"Background and objectives: Sexual assault services in New South Wales (NSW), Australia provide crisis support from a counsellor working with a forensically trained doctor, or nurse, providing medical care and the option of forensic examination. The aim of this paper is to gain an understanding of the experience of recent sexual assault victim-survivors who accessed one of these 24-hour services.Method: A feedback questionnaire was offered to victim-survivors on completion of the integrated crisis response. A descriptive analysis was performed.Results: Results demonstrate that the patients' experiences were positive, with 98% (279/284) recommending a friend that is in the same situation to access the service. Most found the examination reassuring 75% (202) or OK 20% (54), with only 2% (6) reporting it as traumatising and 3% (7) other. Many said the service was not visible enough. Only 4% of patients were referred from general practitioners (GPs).Discussion: The service provided a positive experience for victim-survivors but needs to be more visible. GPs might benefit from increased knowledge of services and referral pathways available to victim-survivors of sexual assault.","PeriodicalId":54241,"journal":{"name":"Australian Journal of General Practice","volume":"54 3","pages":"135-141"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568834","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

Stopping antidepressants or not? 是否停止抗抑郁药？

IF 1.6 4区医学

Australian Journal of General Practice Pub Date : 2025-03-01 DOI: 10.31128/AJGP-09-23-6967

Jeffrey Cl Looi, Stephen Allison, Tarun Bastiampillai, Steve Kisely, Paul A Maguire, Luke Woon, Katrina Anderson

{"title":"Stopping antidepressants or not?","authors":"Jeffrey Cl Looi, Stephen Allison, Tarun Bastiampillai, Steve Kisely, Paul A Maguire, Luke Woon, Katrina Anderson","doi":"10.31128/AJGP-09-23-6967","DOIUrl":"10.31128/AJGP-09-23-6967","url":null,"abstract":"Background: Recently, there has been media and public interest regarding discontinuation of antidepressant treatment, especially in primary care. In this context, we provide a primary care update on the maintenance or discontinuation of antidepressant medication for the treatment of moderate-to-severe depression in adults.Objective: This article aims to provide a primary care update on the maintenance or discontinuation of antidepressant medication for the treatment of moderate-to-severe depression in adults. To this end, we performed a qualitative narrative review and provide commentary on recent research and systematic reviews.Discussion: In primary care, recent research has shown that there are substantial risks of depressive relapse resulting from antidepressant discontinuation. For a first episode of moderate-to-severe depression, antidepressants should be continued for 9-12 months after remission. Systematic reviews indicate that, overall, there is limited evidence of benefits from ceasing antidepressant treatment for recurrent depression. The existing evidence base on antidepressant withdrawal is limited in quality and extent, providing some evidence of harms, such as relapse, and not necessarily any gains, although reducing the burden of adverse effects is a consideration. There is a benefit-to-risk ratio in any decision to continue or withdraw antidepressant treatment.","PeriodicalId":54241,"journal":{"name":"Australian Journal of General Practice","volume":"54 3","pages":"91-94"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568833","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

Experiences of Australian transgender, gender-diverse and non-binary patients accessing and receiving gender-affirming care. 澳大利亚跨性别、多元性别和非二元性别患者获得和接受性别确认护理的经验。

IF 1.6 4区医学

Australian Journal of General Practice Pub Date : 2025-03-01 DOI: 10.31128/AJGP-06-24-7324

Mary Stewart, Aman Bedi, Dash Gray, Joseph Cotter, Catriona Ooi

{"title":"Experiences of Australian transgender, gender-diverse and non-binary patients accessing and receiving gender-affirming care.","authors":"Mary Stewart, Aman Bedi, Dash Gray, Joseph Cotter, Catriona Ooi","doi":"10.31128/AJGP-06-24-7324","DOIUrl":"10.31128/AJGP-06-24-7324","url":null,"abstract":"Background and objectives: It is important for general practitioners (GPs) to understand the barriers and facilitators that transgender, gender-diverse and non-binary patients (TGDNB) experience when accessing health care. The aim of this study was to explore the experiences of patients accessing and receiving gender-affirming care.Method: Patients who attended a sexual health clinic for gender-affirming care (GAC) were invited to participate in a feedback questionnaire that explored the referral process, access to care and perceptions of the clinic.Results: Few patients found out about the service from their GP. Many patients had difficulty accessing GAC but, once aware of services, most had no difficulty obtaining a GP referral. Difficulties accessing GAC included a lack of knowledge from medical professionals, lengthy and complicated processes, cost, confidentiality concerns and being misgendered. Patients found inclusive signage helpful and appreciated being asked about pronouns and chosen name. There was a high level of satisfaction with GAC.Discussion: GPs should be aware of strategies to ensure TGDNB patients feel safe accessing healthcare, including the availability of specialist services and referral pathways.","PeriodicalId":54241,"journal":{"name":"Australian Journal of General Practice","volume":"54 3","pages":"143-151"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568826","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

Management of tuberculosis infection in a general practice setting: An implemented model of care. 在全科医疗环境下结核病感染的管理：一种实施的护理模式。

IF 1.6 4区医学

Australian Journal of General Practice Pub Date : 2025-03-01 DOI: 10.31128/AJGP-05-24-7250

Justin T Denholm, Ann-Marie Baker, Amy VJ Peachey, Fouad Dawood, Bee Cochran

{"title":"Management of tuberculosis infection in a general practice setting: An implemented model of care.","authors":"Justin T Denholm, Ann-Marie Baker, Amy VJ Peachey, Fouad Dawood, Bee Cochran","doi":"10.31128/AJGP-05-24-7250","DOIUrl":"10.31128/AJGP-05-24-7250","url":null,"abstract":"Background: Tuberculosis infection (TBI) is an asymptomatic state in which people have been exposed to Mycobacterium tuberculosis, but not yet developed active disease. Most Australian models of care for TBI have been based in tertiary clinics, but people from affected communities consistently would prefer to receive care in a general practice setting.Objective: This project aimed to develop and implement a model of care for providing safe and effective management of TBI in general practice settings. We describe a pilot program, including training, algorithms for management and resource development, to support holistic care.Discussion: More than 20 general practices and pharmacies in south-eastern Melbourne have now adopted this model of care, involving community-based education, diagnosis and treatment, which has been integrated into existing practice approaches. A range of resources is now available to support general practice clinics in providing TBI care, including both professional development and patient-facing materials.","PeriodicalId":54241,"journal":{"name":"Australian Journal of General Practice","volume":"54 3","pages":"153-156"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568829","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

Health anxiety and somatosensory amplification in adolescents with unexplained chest pain: A comparative study. 青少年不明原因胸痛的健康焦虑和躯体感觉放大：一项比较研究。

IF 1.6 4区医学

Australian Journal of General Practice Pub Date : 2025-03-01 DOI: 10.31128/AJGP-12-23-7074

Berna Gündeş, Yasemin Özkaya, Tülay Demircan, Yusuf Adnan Güçlü, Kayı Eliaçık

{"title":"Health anxiety and somatosensory amplification in adolescents with unexplained chest pain: A comparative study.","authors":"Berna Gündeş, Yasemin Özkaya, Tülay Demircan, Yusuf Adnan Güçlü, Kayı Eliaçık","doi":"10.31128/AJGP-12-23-7074","DOIUrl":"10.31128/AJGP-12-23-7074","url":null,"abstract":"Background and objectives: Chest pain of unknown origin in adolescents might be related to biopsychosocial factors. The aim of this study is to identify the relationship between somatic amplification of bodily sensations and health anxiety in adolescents with unexplained chest pain.Method: The study analysed 111 adolescents with unexplained chest pain at a paediatric cardiology outpatient clinic from June to September 2018, along with a control group of 78 cases. Participants completed a questionnaire featuring the somatosensory amplification scale and a short health anxiety inventory.Results: When comparing the total scores on the somatosensory amplification scale, it was observed that health anxiety and general anxiety scores were higher in the chest pain group. Additionally, the prevalence of suicidal thoughts was found to be more common among adolescents experiencing chest pain.Discussion: Our results highlight the significance of general practitioners taking into account psychosocial factors in adolescents who present with unexplained chest pain and collaborating with them to recognise and address anxiety and suicidal ideation.","PeriodicalId":54241,"journal":{"name":"Australian Journal of General Practice","volume":"54 3","pages":"117-121"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568828","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

SafeScript: Victoria's real-time prescription monitoring system. SafeScript：维多利亚的实时处方监控系统。

IF 1.6 4区医学

Australian Journal of General Practice Pub Date : 2025-03-01 DOI: 10.31128/AJGP-09-23-6972

Malcolm Dobbin

{"title":"SafeScript: Victoria's real-time prescription monitoring system.","authors":"Malcolm Dobbin","doi":"10.31128/AJGP-09-23-6972","DOIUrl":"10.31128/AJGP-09-23-6972","url":null,"abstract":"Background: A substantial increase in prescribing and dispensing of high-risk psychoactive medicines, including opioid analgesics and benzodiazepines, has resulted in an increase in serious harm from use and misuse, including non-fatal and fatal overdose.Objective: The aim of this paper is to describe the need for real-time information about patients' receipt of high-risk psychoactive medicines and the development of SafeScript, Victoria's real-time prescription monitoring system.Discussion: SafeScript uses existing prescription exchange services to collect prescribing and dispensing data about psychoactive medicines subject to misuse or high-risk use. The introduction of SafeScript was accompanied by extensive support measures to encourage and support an effective professional response for patients recognised to be at risk of harm from their use of these medicines. Use is mandatory, and SafeScript is integrated into the professional's workflow. Alerts about several high-risk situations (high opioid daily dose, high-risk medicine combinations, supply by multiple providers) are automatically generated and provided to the professional user at the time of their SafeScript use.","PeriodicalId":54241,"journal":{"name":"Australian Journal of General Practice","volume":"54 3","pages":"96-100"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568361","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

Exploring access to medicinal cannabis through general practitioners in Australia. 探索通过全科医生在澳大利亚获得药用大麻。

IF 1.6 4区医学

Australian Journal of General Practice Pub Date : 2025-03-01 DOI: 10.31128/AJGP-02-24-7155

Sophia Martin, Sarah Jansen, Annalisa Toole, Aletha Ward

{"title":"Exploring access to medicinal cannabis through general practitioners in Australia.","authors":"Sophia Martin, Sarah Jansen, Annalisa Toole, Aletha Ward","doi":"10.31128/AJGP-02-24-7155","DOIUrl":"10.31128/AJGP-02-24-7155","url":null,"abstract":"Background and objectives: Patient access to medicinal cannabis (MC) is impacted by several factors, despite legalisation of it for medicinal and related scientific purposes in 2016. This scoping review aimed to examine the barriers and enablers to accessing MC through general practitioners (GPs) in Australia.Method: Scientific and grey literature meeting inclusion criteria were identified from 2016 to 2023, resulting in 11 papers and 40 webpages being included in this review.Results: Many GPs reported inadequate knowledge surrounding MC, forming a barrier to their approachability to discussion with patients. Living rurally and earning less money were barriers to patients' ability to seek MC. Telehealth cannabis clinics lessened geographical barriers, but not financial barriers.Discussion: Although stigma and demographic access barriers to MC are decreasing with cultural, industry and healthcare system shifts, inequitable access is still occurring due to the economic burden on patients. GPs reported having difficulties in navigating the prescribing process and accessing the most up-to-date evidence for clinical use due to time scarcity.","PeriodicalId":54241,"journal":{"name":"Australian Journal of General Practice","volume":"54 3","pages":"101-108"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568827","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

Beyond the clinic door: That which is between. 诊所门外：中间的东西。

IF 1.6 4区医学

Australian Journal of General Practice Pub Date : 2025-03-01

引用次数: 0