Aust Fam Physician
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A polymorphism is a variant within a gene that does not necessarily affect its function, unlike a pathogenic mutation. Genetic testing for two common polymorphisms in the methylenetetrahydrofolate reductase gene (MTHFR), 677C>T and 1298A>C, is being accessed by general practitioners (GPs) and alternative medicine practitioners (based on in-house records from referrals), and promoted through some pharmacies in Western Australia (based on the authors' personal communication). Due to the large, varied and often conflicting data reported on MTHFR, these polymorphisms have been weakly associated with multiple conditions, including autism, schizophrenia, cardiac disease, fetal neural tube defects, poor pregnancy outcomes and colorectal cancer. ⋯ On the basis of the available scientific evidence, we propose that there are very limited clinical indications for testing for the 677C>T and the 1298A>C polymorphisms in the MTHFR gene, and that testing is not indicated as a non-specific screening test in the asymptomatic general population.
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Many general practitioners (GPs) struggle to meet the demand for their services at residential aged care facilities (RACFs). The aim of this study was to describe and examine the effect on service provision and GPs of a new model of RACF care in a rural general practice. ⋯ This service model has much to offer GPs who are willing to engage in team care. It is an efficient model of high-quality care that overcomes key barriers associated with providing sustainable general practice services to RACF residents.
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Children in Australia are infrequent recipients of general practitioner (GP) home visits. ⋯ There is infrequent use of home-visiting GP services by children who present to EDs with lower urgency conditions. These services refer some children with low-urgency conditions to the ED.