Aust Fam Physician
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To explore ethical challenges for general practitioners teaching medical students in urban general practice. Methods Semistructured face-to-face interviews with 60 urban general practice teachers with diverse teaching loads and practice demographics. Interview data were analysed following member checking of interview records. ⋯ General practice teachers should consider modelling seeking informed patient consent in difficult circumstances, while being mindful that patients may be reluctant to refuse or withdraw consent. Arguably students themselves should seek consent. General practitioners should consider maintaining the confidentiality of previously divulged patient information. Concerns about active student involvement in teaching consultations should be discussed with teaching colleagues from similar practice demographics, with reference to pertinent literature about patient attitudes to teaching.
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Lactational mastitis is common, affecting one in 5 breastfeeding women. As well as causing significant discomfort, it is a frequent reason for women to stop breastfeeding. ⋯ Lactational mastitis is usually bacterial in aetiology and can generally be effectively managed with oral antibiotics. Infections that do not improve rapidly require further investigation for breast abscess and nonlactational causes of inflammation, including the rare cause of inflammatory breast cancer. In addition to antibiotics, management of lactational breast infections include symptomatic treatment, assessment of the infant's attachment to the breast, and reassurance, emotional support, education and support for ongoing breastfeeding.
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Traumatic brain injury is a significant cause of disability worldwide. Patients with a traumatic brain injury may have a range of physical, mental, cognitive and social problems involving care from a general practitioner. ⋯ The long term sequelae of traumatic brain injury pose a number of challenges for patients, their families and GPs. Common somatic complaints include seizures, headache, dizziness and sleep disturbance. Common mental health problems include depression, psychosis and anxiety. Cognitive and behavioural or personality changes can be significant and persist for some time following injury. Quality of life is closely predicted by return to the workforce and long term functional status is often linked to the severity of the injury. There is limited evidence for effective treatments of these sequelae and a need for more research. However, there are a number of proven treatments and an emerging understanding of the long term sequelae of traumatic brain injury.