Aust Fam Physician
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Acute rheumatic fever is a rare multisystem disease caused by an immunological response to Group A streptococcus infection. Acute rheumatic fever usually has onset in childhood and is most prevalent in Aboriginal and Maori populations and other disadvantaged groups. ⋯ Recurrent episodes of acute rheumatic fever may lead to rheumatic heart disease. Early detection of acute rheumatic fever and provision of secondary prophylaxis with antibiotics is paramount to the prevention of rheumatic heart disease. Primary healthcare providers can play an important role in identifying acute rheumatic fever and ensuring adherence to treatment within the context of a complex interplay of cultural and socioeconomic factors. The recent establishment of RHD Australia will support the development of appropriate educational resources and their dissemination among health professionals and vulnerable communities.
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In the United Kingdom, the General Medical Council aims to introduce revalidation for all medical doctors from 2012, in response to public and government pressure. Doctors will submit evidence to support their fitness to practise medicine every 5 years in relation to the four domains and 12 attributes of good medical practice. ⋯ A revalidation process is being piloted in several parts of the United Kingdom with a view to implementation in 2012. However, there is a lack of evidence internationally that revalidation or relicensure identifies doctors who are performing poorly. The medical profession in Australia needs to reflect on whether this model is one it wishes to consider.
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Due to the projected increase of medical graduates and general practice registrars, a rapid increase in new trainers and practices is required. The resulting mix of relatively inexperienced trainers and trainees makes the examination of the important question of patient safety even more pertinent. ⋯ Trainees can both be conscious of their incompetence and ask for help, or unconscious of their incompetence. Many articles have been written on teaching trainees who ask for help, but it is the trainee who does not ask for help who may be at most risk of serious problems, and therefore compromise patient safety. Formative assessment and feedback should be used to empower trainees as self-regulated learners. There are seven principles of good feedback practice that help develop self-regulation. This article provides practical teaching tips for supervisors in general practice.
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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.