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Marketing Interprofessional Education and learning and Collaborative Practice in Countryside Wellbeing Adjustments: Learnings from a State-Wide Multi-Methods Research.
Higher-order learning outcomes will be explored in future training programs.Background Lessons from previous pandemics emphasise the importance of consistent information and advice for healthcare workers (HCWs), particularly in relation to their use of personal protective equipment (PPE). Objective The aim of this article is to review the consistency of advice regarding HCW use of PPE among Australian states and territories and 10 key Australian professional and advocacy organisations, against the Australian Government's national guidelines. Discussion While some recommendations expand on the national guidelines, the Australian Government's efforts to work in concert with states, territories and peak professional and advocacy organisations are evident in the broadly consistent recommendations for the use of PPE by HCWs and other people working in healthcare settings across the country. The overall consistency of recommendations for the use of PPE shows a nationwide attempt to support and protect the healthcare workforce and the Australian community during the COVID-19 pandemic.Background and objectives In Australia, the uptake of the sentinel lymph node biopsy (SLNB) appears low despite clinical practice guideline recommendations. The aim of this study was to describe the knowledge and attitudes of general practitioners (GPs) to SLNB. Method GPs were recruited at an annual conference and a skin cancer skills workshop, and using GP professional communications. A mixed methods approach comprised a cross-sectional questionnaire and, for a subset of participants, semi-structured interviews. Results Overall, 231 GPs completed the questionnaire, of whom 23 were interviewed. One-third (32%) described themselves as quite or very familiar with the guidelines, and two-thirds (68%) thought that SLNB had an important role in the management of patients with melanoma. Of GPs who would discuss SLNB with eligible patients, 1 mm thick. Discussion GPs were generally supportive of SLNB. Familiarity with the guidelines was low, particularly regarding which patients should be considered for SLNB.Background Medical abortion (using mifepristone followed by misoprostol to end an early pregnancy) is a more accessible and less invasive option than surgical termination and can be provided in primary care settings. However, few general practitioners (GPs) currently provide this service, and there remains great inequity in access to abortion across Australia, particularly for young women and those living in rural and remote area. Objective The aim of this article is to help Australian GPs better understand the practical and legal considerations of providing medical abortion to patients. Discussion Provision of medical abortion is well within the scope of community general practice and improves the comprehensiveness of women's sexual and reproductive health services that GPs can deliver. This article will help GPs to better understand the process involved in providing medical abortion, including the practical considerations for patients; be better equipped to support patients who have decided that medical abortion is an appropriate choice for them; and make an informed decision as to whether to become a provider of medical abortion.Background Teenage pregnancy rates are falling in many high-resource settings, but for those who do conceive, the socioeconomic and educational disadvantage that ensues is often long lasting and intergenerational. The adverse maternal and neonatal outcomes can be ameliorated through antenatal and postnatal care that attends to the special needs of this group. Objective The aim of this article is to provide an overview of the social, obstetric and medical complications of teenage pregnancy and the role of the general practitioner (GP) in mitigating adverse outcomes. Discussion Management and prevention of teenage pregnancy requires broad efforts that involve schools, health services and the community. The GP has a key role in providing supportive continuity of care that spans the antenatal and crucial postnatal periods.Background An assessment of female fertility may be undertaken in the general practice setting for a variety of reasons. These include concerns about future fertility when pregnancy is not immediately planned, a desire to consider elective oocyte cryopreservation and difficulty conceiving. Objective The aim of this article is to summarise indications, rationale and components of a comprehensive female fertility assessment in a primary care setting. Discussion The primary care physician has an essential role in providing women with guidance, counselling and assessment regarding fertility concerns. A complete initial assessment includes pre-pregnancy screening and counselling, and assessment of ovulation, ovarian reserve and pelvic anatomy to guide further investigation and management.Background The importance of interconception care - defined as care given to women, and their partners, between one pregnancy and the next to optimise their health - is increasingly important, with rising rates of overweight, obesity, diabetes and hypertension among people of reproductive age. Women frequently visit their general practitioner (GP) in the first six months postpartum. This is an opportune time to discuss ideal interpregnancy intervals (IPIs) and advise women about contraception and healthy behaviours. Objective The aim of this article is to review available research and guidelines on interconception care and IPIs, and propose best-practice care for the general practice setting. Discussion GPs are uniquely placed to deliver the different aspects of interconception care including reviewing the outcomes of the previous pregnancy, advising women on optimal IPIs and providing contraception and lifestyle guidance. Studies have found that GPs may feel they lack the time and resources to provide interconception care, but support is available through online tools and easy-to-access checklists. As the prevalence of obesity and chronic diseases increases, interconception care has the potential to reduce future adverse perinatal outcomes.Background and objectives Medical abortion is safe and effective and, when provided by general practitioners (GPs), can increase access for women. However, little is known about which models Australian GPs use to deliver medical abortion. The aim of this study was to describe GP medical abortion delivery models. Method Semi-structured telephone interviews were conducted with GPs providing medical abortion nationwide. Data were transcribed, thematically analysed by two researchers and interpreted using six quality dimensions. Results Twenty-five GPs used three medical abortion models in private practice common, streamlined and ultrasonography-inclusive. The most common model comprised three appointments. Some participants provided medical abortion over 1-2 appointments ('streamlined'), and few provided ultrasonography themselves ('ultrasonography-inclusive'). Clinician networks supported participants and enhanced medical abortion delivery. Discussion Using three appointments for delivering medical abortion may be less acceptable and accessible to women than streamlined or ultrasonography-inclusive models. Increased awareness of the alternative medical abortion models may encourage GP medical abortion delivery and increase access for women.Background Knee pain is a common symptom in the community. There is a wide range of conditions that can cause pain. Identifying the type and severity of the condition is important for effective management. There are several guidelines for the appropriate imaging of patients presenting with knee pain. Presentation is generally divided into a post-traumatic group and those without known trauma (including arthritis). Objective The aim of this article is to discuss the approach to imaging of the knee with reference to Diagnostic Imaging Pathways and illustrate some of the conditions that may be encountered. Discussion The initial workup is typically done in general practice to determine which patients require referral for specialist management and which patients can be cared for in the community. Most cases presented in this article are patients referred from primary care to a metropolitan radiology practice during a six-month period, and they represent examples of some of the more common pathologies.Background Opioids are frequently used to manage chronic non-cancer pain despite the lack of evidence of benefit and clear evidence of opioid-related harms. Patients undergoing high-dose opioid therapy are at risk of multiple complications, such as opioid toxicity, including fatal overdose and opioid dependence. Objective This article provides an overview of the pharmacology of buprenorphine and reviews current evidence for the use of high-dose sublingual buprenorphine-naloxone in the pharmacological management of patients at high risk of complications from chronic opioid use. Discussion Buprenorphine-naloxone is well tolerated by patients with chronic pain, and has the potential to improve pain scores and affective symptoms. see more This is exemplified in a case study based on these authors' experience in an addiction medicine setting. As the rates of pharmaceutical opioid prescribing and related harms continue to increase in Australia, buprenorphine-naloxone is a viable option to manage high-risk chronic pain patients who are unable to reduce or cease their opioid use.Objective To investigate the efficacy and pregnancy outcome of fertility-preserving treatment for patients with stage Ⅰa, grade 2 endometrial cancer (EC). Methods Clinical data was retrospectively collected for EC or atypical endometrial hyperplasia (AEH) patients treated in Peking University People's Hospital, Foshan First People's Hospital of Guangdong Province and First Affiliated Hospital of Sun Yat-sen University, from 2010 to 2019. Inclusion criteria for fertility-preserving treatment included (1) Age ≤45 years. (2) EC with histological differentiation of G(1), G(2) or endometrial AEH. (3) EC disease should be stage Ⅰa, confined to the endometrium without myometrial invasion, lymph node or extrauterine metastasis. Treatment regimen patients were given oral progestin therapy and endometrial pathology was evaluated every three months. Patients were divided into three groups as G(2) EC group, G(1) EC group and AEH group based on the histological differentiation. Oncological and pregnancy outcomes were compncy was shorter in G(2) EC patientsthan the other two groups (4, 9 and 22 months, respectively; P=0.006). Conclusions Fertility-preserving treatment for patients with stageⅠa, G(2) endometrial cancer, may obtain a relatively high remission rate and an acceptable pregnancy rate. However, further exploration is needed due to the limited number of cases.Objective To explore the preliminary clinical values of colposcopy in the diagnosis of vaginal invasion in cervical cancer. Methods A retrospective review of the clinical records of patients (31 cases) with cervical cancer treated in Xuzhou Cancer Hospital from April 2015 to August 2019. For those with early-stage cervical cancer and the vagina invasion being difficult to be determined, those with advanced cervical cancer and the scope of vaginal invasion being difficult to be judged, and those with obvious vaginal tumor and underexposed cervix or inconspicuous cervical lesion and the primary location needing to be identified, colposcopy-guided vaginal and cervix biopsy were performed before treatment. Results (1) Image characteristics of colposcopy and pathological diagnosis among 31 cases, 30 of them had the similar images of vagina and cervix. The images were dense acetowhite and (or) thick mosaic, coarse punctate and atypical vessels. Lugol's staining was uniformly bright yellow or brown. Pathological biopsy of vaginal wall 27 cases were metastatic carcinoma, 3 cases were vaginal intraepithelial neoplasia (VaIN) Ⅱ-Ⅲ.
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