Aust Fam Physician
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Aerobic exercise has a marked impact on cardiovascular disease risk. Benefits include improved serum lipid profiles, blood pressure and inflammatory markers as well as reduced risk of stroke, acute coronary syndrome and overall cardiovascular mortality. Most exercise programs prescribed for fat reduction involve continuous, moderate aerobic exercise, as per Australian Heart Foundation clinical guidelines. ⋯ Aerobic exercise has numerous benefits for high-risk populations and such benefits, especially weight loss, are amplified with HIIT. High intensity interval training involves repeatedly exercising at a high intensity for 30 seconds to several minutes, separated by 1-5 minutes of recovery (either no or low intensity exercise). HIT is associated with increased patient compliance and improved cardiovascular and metabolic outcomes and is suitable for implementation in both healthy and 'at risk' populations. Importantly, as some types of exercise are contraindicated in certain patient populations and HIIT is a complex concept for those unfamiliar to exercise, some patients may require specific assessment or instruction before commencing a HIIT program.
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Dementia is an increasingly common condition in the community. On average, every general practitioner in Australia will see three new cases each year. There are strong reasons for making an early diagnosis of dementia, as this may enable families to plan ahead and to institute management that could reduce cognitive impairment and slow disease progression. ⋯ Several new strategies for the management of dementia have emerged recently and GPs should be aware that optimal management of cardiovascular risk factors will improve cognition and may delay onset. Management of exercise, socialisation and cognitive training may improve cognitive function in early-diagnosed cases. The GP's role in initiating service delivery is an important one, and the practice nurse may play an important role in coordinating services for patients in the early stages of dementia.
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The reduction in smoking in Australia in the past 30 years has established the conditions in which elimination of smoking should now be considered. This is sometimes referred to as the 'tobacco endgame'. A range of approaches can be considered and any that are implemented would build on current actions such as plain packaging. ⋯ The most effective strategy for eliminating smoking in Australia is likely to be one that reverses the tolerable, addictive nature of modern tobacco by the elimination of all additives and by specifying a very low level of true nicotine delivery. Use of an unsatisfying, costly and toxic product would naturally, and rapidly, decline.
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General practitioners are usually the first point-of-contact for young people seeking sexual health and contraceptive advice. Although the combined oral contraceptive pill is still the most common choice for contraception by Australian women, there is an increasing drive to encourage the consideration and use of long acting reversible contraception. ⋯ If presented with information about the range of contraceptive choices, including long acting reversible contraception, young women will commonly choose a longer acting method. Good counselling is important before advocating either implant or depot injections as irregular bleeding can occur and is likely to be of particular concern to younger women. Clinicians are increasingly considering intrauterine devices in nulliparous women and in women aged less than 25 years. It is uncommon for women to have complications with intrauterine device insertion, the most significant potential problem being pelvic infection. The key to minimising problems in contraceptive practice is the consideration of sustainability (cost, efficiency, duration of action and suitability), making a careful choice and then counselling the patient well.
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Comparative Study
Infertility: management in Australian general practice.
From April 2007 to March 2012 in the BEACH (Bettering the Evaluation and Care of Health) program, infertility/subfertility was managed at 652 encounters with 534 general practitioners (1.3 per 1000 encounters).