Aust Fam Physician
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Review Case Reports
Disenfranchised grievers--the GP's role in management.
Disenfranchised grief results from a loss that is not or cannot be openly acknowledged, publicly mourned, or socially supported. This article aims to explain the concept and varying presentations of disenfranchised grief and outlines the importance of the general practitioner's role. ⋯ Disenfranchised grievers present with various symptoms, however, primary care has focused on mental illness, with little recognition of loss and grief issues, especially disenfranchised grief. Further research is required and currently underway to design and formally test a model that can be implemented within an Australian fee-for-service setting.
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Chemotherapy induced nausea and vomiting are among the most feared consequences of cancer treatment. Recent developments in drug treatment make the goal of no nausea or vomiting during chemotherapy realistic. ⋯ Regimens to prevent chemotherapy induced nausea and vomiting are guided by the emetogenic potential of the chemotherapeutic agents used. Combined prophylactic therapy targets different pathways, improving the efficacy of prevention and treatment of chemotherapy induced nausea and vomiting. General practitioners have an important role in patients undergoing chemotherapy by reinforcing the importance of prophylactic treatment and administering rescue treatment for patients with breakthrough or prolonged nausea and vomiting postchemotherapy.
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Review
Nurse practitioners and GPs--addressing the needs of older persons living in residential aged care.
The Australian population is becoming progressively older, placing significant pressure on both the supply of supported accommodation and health services. Collaboration between general practitioners and nurse practitioners over the care of people living in residential aged care facilities has the potential to promote continuity of care, decrease hospitalisations and readmissions, enhance patient satisfaction, reduce costs, enhance working relations between medicine and nursing, and improve residents' access to care. It will require improved communication and the overcoming of several attitudinal and organisational barriers.
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The World Health Organisation estimates that 2 billion people have been infected with hepatitis B and about 180 million people infected with hepatitis C worldwide. More than 350 million have chronic hepatitis B and 130 million have chronic hepatitis C infection. Most infections of hepatitis B and C are from unsafe injection practices, both medical and nonmedical; from household contacts; or, in the case of hepatitis B, from 'vertical' transmission from mother to child. ⋯ Most people carrying hepatitis will be asymptomatic with infection detected by screening. Refugees need counselling, education and support to come to terms with the implications of hepatitis B and C for both themselves and their families. In Australia both viruses can be treated in those with active infection and general practitioners can be involved in diagnosis, follow up and shared care management.